Individual provider Active NPI

Ronald Tobin

  • Physical Therapy Assistant
  • Excelsior, MN
National Provider Identifier
1881467355
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A2945 Issued in MN
Practice address
4960 Rustic Way
Excelsior, MN 55331-8680
Phone
(952) 200-1218
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A2945 MN Primary

Addresses

Primary practice location

4960 Rustic Way
Excelsior, MN 55331-8680

Mailing address

4960 Rustic Way
Excelsior, MN 55331-8680

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A2945MNMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1881467355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 RUSTIC WAY",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553318680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 RUSTIC WAY",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553318680",
            "telephone_number": "952-200-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "RONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.