Dennis J McEntaffer, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5704 Issued in MN

Practice address

1512 Service Dr
Winona, MN 55987-3803

Phone

(507) 474-6900

Fax

(507) 474-0502

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sport & Spine Physical Therapy of Winona, Inc

  • Physical Therapist
  • Winona, MN
  • NPI 1467510750
  Medicare reassignment

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1750352902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 SERVICE DR",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873803",
            "telephone_number": "507-474-6900",
            "fax_number": "507-474-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 SERVICE DR",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873803",
            "telephone_number": "507-474-6900",
            "fax_number": "507-474-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTAFFER",
        "first_name": "DENNIS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "839662100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas W McCasland
• Samanthajo McClatchey
• Eileen Rose McCormick
• Miranda Ann McDannold
• Gabriella Pearl McDowell
• Anastasia Love McFarlane
• Destiny McGeough
• Robert C McMahon, OD
• Robert E McManimon Moe, BS, ADC-T
• Raquela McManimon-Myers

• Physical Therapist in Winona, MN
• Providers in Winona, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.