Individual provider Active NPI

Andrea Marie Wendt, DPT

  • Physical Therapist
  • Saint Paul, MN
National Provider Identifier
1922544162
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10946 Issued in MN
Practice address
30 Fairview Ave S Ste 200
Saint Paul, MN 55105-1463
Phone
(952) 835-4512
Fax
(888) 425-0398
NPI assigned
Jan 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13391 WI
Physical Therapist 225100000X 10946 MN Primary

Addresses

Primary practice location

30 Fairview Ave S Ste 200
Saint Paul, MN 55105-1463

Mailing address

7825 3Rd St N Ste 105
Oakdale, MN 55128-5403
Phone (952) 835-4512

Other names 1

  • Dr. Andrea Marie Vivian Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171101002687 MN Practitioner - Physical Therapist in Private Practice 3779849062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
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)

30 Fairview Ave S
Suite 200
Saint Paul, MN 55105-1463
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
10946MNMDPhysical Therapist
13391WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Oct 15, 2019 Accepting new patients
Novacare Outpatient Rehabilitation East Inc Physical Therapist Current Accepting new 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
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Oct 15, 2019 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

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

10091 Dogwood St NW
Minneapolis, MN 55448
Phone (763) 450-0298

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

30 Fairview Ave S
#200
Saint Paul, MN 55105

Organizations & group practices 6

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": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1922544162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 3RD ST N STE 105",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285403",
            "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": "30 FAIRVIEW AVE S STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051463",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13391",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "VIVIAN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.