Individual provider Active NPI

Molly K Mattison, PT

  • Physical Therapist
  • Eagan, MN
National Provider Identifier
1902689292
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13276 Issued in MN
Practice address
3365 Central Park Village Dr Ste 100
Eagan, MN 55121-7707
Phone
(877) 609-0123
Fax
(888) 425-0398
NPI assigned
Aug 18, 2023
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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 13276 MN Primary

Addresses

Primary practice location

3365 Central Park Village Dr Ste 100
Eagan, MN 55121-7707

Mailing address

683 Maple St
Wabasso, MN 56293-1614

Other names 1

  • Molly Stark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Aug 14, 2023 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

3365 Central Park Village Dr
#100
Eagan, MN 55121

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1902689292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 MAPLE ST",
            "city": "WABASSO",
            "state": "MN",
            "postal_code": "562931614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 CENTRAL PARK VILLAGE DR STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551217707",
            "telephone_number": "877-609-0123",
            "fax_number": "888-425-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "MOLLY",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "STARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.