NPIMap

Organization Active NPI

Rehabilitation Consultants, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Eagan, MN
National Provider Identifier
1710040456
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
45600 Issued in MN
Legal business name
REHABILITATION CONSULTANTS, INC.
Practice address
880 Blue Gentian Rd
Suite 150
Eagan, MN 55121-1669
Phone
(651) 379-1600
Fax
(651) 379-1650
NPI assigned
Dec 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Elena Lev Polukhin, MD
Title
Medical Director
Phone
(651) 699-0633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 45600 MN Primary

Addresses

Primary practice location

880 Blue Gentian Rd
Suite 150
Eagan, MN 55121-1669

Mailing address

3006 Frank St
Maplewood, MN 55109-5501
Phone (651) 699-0633

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1710040456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 FRANK ST",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095501",
            "telephone_number": "651-699-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 BLUE GENTIAN RD",
            "address_2": "SUITE 150",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211669",
            "telephone_number": "651-379-1600",
            "fax_number": "651-379-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-17",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "POLUKHIN",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "LEV",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "651-699-0633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "45600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.