Individual provider Active NPI

Jordan Litschewski, DPT

  • Physical Therapist
  • Maplewood, MN
National Provider Identifier
1912571100
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12233 Issued in MN
Practice address
2515 White Bear Ave N Ste A11
Maplewood, MN 55109-5118
Phone
(651) 275-4706
NPI assigned
May 13, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12233 MN Primary
Physical Therapist 225100000X NU
Orthopedic Physical Therapist 2251X0800X NU

Addresses

Primary practice location

2515 White Bear Ave N Ste A11
Maplewood, MN 55109-5118

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210625001054 MN Practitioner - Physical Therapist in Private Practice 0244631463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Partners IncGroup PAC ID 4486552593, 135 clinicians

Practice addresses (Care Compare)

1700 Tower Dr W
Stillwater, MN 55082-7511
Phone (651) 439-8540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12233MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Partners, Inc. Physical Therapist CurrentSince Jun 10, 2021 Accepting new patients
Therapy Partners Inc Physical Therapist CurrentSince Jun 10, 2021 Accepting new patients

Locations

2515 White Bear Ave N
Ste A11
Maplewood, MN 55109
Phone (651) 229-5466

1939 Minnehaha Ave W
Ste 300
Saint Paul, MN 55104

7581 9th St N
Ste 100
Saint Paul, MN 55128

1700 Tower Dr W
Stillwater, MN 55082
Phone (651) 275-4706

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1912571100",
    "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": "2515 WHITE BEAR AVE N STE A11",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095118",
            "telephone_number": "651-275-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITSCHEWSKI",
        "first_name": "JORDAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12233",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.