Individual provider Active NPI

Amanda Kathryn Hilligoss, DPT

  • Physical Therapist
  • Fridley, MN
National Provider Identifier
1922361328
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2894 Issued in MN
Practice address
6401 University Ave NE
Fridley, MN 55432-4320
Phone
(763) 586-5844
NPI assigned
Jun 20, 2012
Last updated
Dec 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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 2894 MN Primary

Addresses

Primary practice location

6401 University Ave NE
Fridley, MN 55432-4320

Mailing address

6401 University Ave NE
Fridley, MN 55432-4320
Phone (763) 586-5844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121121000532 MN Practitioner - Physical Therapist in Private Practice 1456502418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

290 Main St NW
Suite 100
Elk River, MN 55330-1251
Phone (763) 241-5800

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2894MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jan 17, 2018 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Apr 7, 2021 Accepting new patients
Fairview Health Services CurrentSince Jan 17, 2018 Accepting new patients
Fairview Express Care CurrentSince Apr 7, 2021 Accepting new patients
Fairview Express Care Past Accepting new patients

Locations

15650 Cedar Ave
Ste 160
Apple Valley, MN 55124
Phone (952) 997-4170

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

6545 France Ave S
Ste 450A
Edina, MN 55435
Phone (952) 920-8525

800 Freeport Ave NW
Ste 200
Elk River, MN 55330
Phone (612) 672-5775

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

6401 University Ave NE
Minneapolis, MN 55432
Phone (763) 572-5706

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

Organizations & group practices 8

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1922361328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324320",
            "telephone_number": "763-586-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324320",
            "telephone_number": "763-586-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIGOSS",
        "first_name": "AMANDA",
        "middle_name": "KATHRYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.