Individual provider Active NPI

Renata Anne Braudy, PT

  • Physical Therapist
  • Minnetonka, MN
National Provider Identifier
1821159831
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9160 Issued in MN
Practice address
5959 Baker Rd Ste 340
Minnetonka, MN 55345-5984
Phone
(651) 348-7428
Fax
(651) 348-7432
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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 5989 AZ
Physical Therapist 225100000X 9160 MN Primary

Addresses

Primary practice location

5959 Baker Rd Ste 340
Minnetonka, MN 55345-5984

Mailing address

7581 9TH St N Ste 100
Oakdale, MN 55128-6635
Phone (651) 748-4338

Other identifiers 1

IdentifierTypeStateIssuer
756140MedicaidAZ

Other names 1

  • Renata Braudy Beaman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121114000606 MN Practitioner - Physical Therapist in Private Practice 2466550777

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2066 Stone Creek Dr
Chanhassen, MN 55317-7410

4200 Dahlberg Dr
Suite 300
Golden Valley, MN 55422-4836

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9160MNMDPhysical Therapist
5989AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Jan 22, 2024 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jan 22, 2024 Accepting new patients
KC'S Physical Therapy LLC Past Accepting new patients
Spooner Phoenix Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

4100 Minnesota Dr
Edina, MN 55435
Phone (952) 456-7000

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

6600 France Ave S
Ste 260
Minneapolis, MN 55435
Phone (952) 922-0330

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1821159831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 9TH ST N STE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286635",
            "telephone_number": "651-748-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 BAKER RD STE 340",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455984",
            "telephone_number": "651-348-7428",
            "fax_number": "651-348-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUDY",
        "first_name": "RENATA",
        "middle_name": "ANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-07-08",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5989",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756140",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENATA",
            "last_name": "BEAMAN",
            "middle_name": "BRAUDY",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.