Active NPI
Blake Scott Buetow, DPT
- Orthopedic Physical Therapist
- Vadnais Heights, MN
National Provider Identifier
1811027980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 7587
- Practice address
- 1155 County Road E E Ste 120
Vadnais Heights, MN 55110-5191 - Phone
- (651) 241-1464
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 7587 | MN | Primary |
Addresses
Primary practice location
1155 County Road E E Ste 120
Vadnais Heights, MN 55110-5191
Mailing address
1155 County Road E E Ste 120
Vadnais Heights, MN 55110-5191
Phone (651) 241-1464
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 052N1BU | Other | BLUE CROSS BLUE SHIELD | |
| 765105000 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Past | Accepting new patients | |
| Body Balance Golf & Physical Therapy, LLC | Past | Accepting new patients | |
| Allina Health System | Past | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Interoperability endpoints
- bbuetow50571@excellian.direct.allina.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1760446256
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
-
- Physical Therapist
- Bloomington, MN
- NPI 1023014859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586304000000",
"number": "1811027980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 COUNTY ROAD E E STE 120",
"city": "VADNAIS HEIGHTS",
"state": "MN",
"postal_code": "551105191",
"telephone_number": "651-241-1464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 COUNTY ROAD E E STE 120",
"city": "VADNAIS HEIGHTS",
"state": "MN",
"postal_code": "551105191",
"telephone_number": "651-241-1464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUETOW",
"first_name": "BLAKE",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2020-04-08",
"certification_date": "2020-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MN",
"license": "7587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "052N1BU",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "765105000",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vadnais Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.