Individual provider Active NPI

Kera Noel Madsen, DPT

  • Physical Therapist
  • Minnetonka, MN
National Provider Identifier
1831381003
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7974 Issued in MN
Practice address
12324 Wayzata Blvd Ste 100
Minnetonka, MN 55305-1919
Phone
(952) 835-4512
Fax
(888) 425-0398
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7974 MN Primary

Addresses

Primary practice location

12324 Wayzata Blvd Ste 100
Minnetonka, MN 55305-1919

Mailing address

7825 3Rd St N
Ste105
Oakdale, MN 55128-5444
Phone (952) 835-4512

Other identifiers 1

IdentifierTypeStateIssuer
115593OtherMNOPTUM (UNITED HEALTH CARE)

Other names 1

  • Kera Noel Wayne Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204000788 MN Practitioner - Physical Therapist in Private Practice 2961835095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

12324 Wayzata Blvd
Minnetonka, MN 55305-1919
Phone (877) 609-0123

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
7974MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2023 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

6520 150th St W
Ste 100
Apple Valley, MN 55124

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

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

12324 Wayzata Blvd
Minnetonka, MN 55305
Phone (528) 354-5129

12324 Wayzata Blvd
Ste 100
Minnetonka, MN 55305

3912 Excelsior Blvd
St Louis Park, MN 55416
Phone (528) 354-5129

Organizations & group practices 3

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1831381003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 3RD ST N",
            "address_2": "STE105",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285444",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12324 WAYZATA BLVD STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051919",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "KERA",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM (UNITED HEALTH CARE)",
            "identifier": "115593",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERA",
            "last_name": "WAYNE",
            "middle_name": "NOEL",
            "credential": "DPT",
            "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 19, 2021; 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.