Individual provider Active NPI

Mandy Labrosse, PT

  • Physical Therapist
  • Prior Lake, MN
National Provider Identifier
1770628356
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8448 Issued in MN
Practice address
4646 Colorado St SE Ste 2
Prior Lake, MN 55372-4548
Phone
(952) 936-9600
Fax
(952) 936-9536
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT018539 PA
Physical Therapist 225100000X 8448 MN Primary

Addresses

Primary practice location

4646 Colorado St SE Ste 2
Prior Lake, MN 55372-4548

Mailing address

1939 Minnehaha Ave W Ste 300
Saint Paul, MN 55104-1033
Phone (651) 748-4338

Other practice location 1

4956 Lincoln Dr
Edina, MN 55436-1071
Phone (952) 936-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100415000866 MN Practitioner - Physical Therapist in Private Practice 5799812194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Partners IncGroup PAC ID 4486552593, 135 clinicians

Practice addresses (Care Compare)

4956 Lincoln Dr
Edina, MN 55436-1071
Phone (952) 936-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT018539PAMDPhysical Therapist
8448MNMDGerontology Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1770628356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MINNEHAHA AVE W STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041033",
            "telephone_number": "651-748-4338",
            "fax_number": "651-748-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 COLORADO ST SE STE 2",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553724548",
            "telephone_number": "952-936-9600",
            "fax_number": "952-936-9536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4956 Lincoln Dr",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554361071",
            "country_code": "US",
            "telephone_number": "952-936-9600",
            "fax_number": "952-936-9536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABROSSE",
        "first_name": "MANDY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018539",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.