Joel Allen Bengtson, PT
Individual provider Active NPI Orthopedic Physical Therapist · Saint Paul, MN
NPI 1932178563 · NPPES record last updated Jul 1, 2015
Key facts
- NPI
- 1932178563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 5490 (MN)
- Practice address
- 1661 Saint Anthony Ave
Saint Paul, MN 55104-3733 - Phone
- (651) 842-5335
- Fax
- (651) 730-3989
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Orthopedics, LTD
Practice addresses (Care Compare)
1661 Saint Anthony Ave
Saint Paul, MN 55104-7633
Phone (651) 968-5300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110331000879 | MN | Practitioner - Physical Therapist in Private Practice | 0244413003 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5490 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Orthopedics, LTD. | Current |
Accepting new patients | |
| Summit Orthopedics LTD | Current |
Accepting new patients | |
| Summit Orthopedics, LTD | Orthopedic | Current | Accepting new patients |
| Summit Orthopedics, LTD. | Past | Accepting new patients |
Locations
1661 Saint Anthony Ave
Fl 1
Saint Paul, MN 55104
Phone (651) 968-5600
1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300
2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142
3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5600
2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801
710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 5490 | MN | Yes |
Addresses
Primary practice location
1661 Saint Anthony Ave
Saint Paul, MN 55104-3733
Mailing address
710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00012115 | Other | MN | RAILROAD MEDICARE |
Other providers in Saint Paul, MN
- Lewis Benedict
- Luke E Benedict
- Janet S Beneke
- Benevolent Care LLC
- Francis J Benfante
- Naima Benhaddou
- Rhegan Benicke
- Terrie-Ann Sanya Benjamin
- Natasha Marie Benkovich
- Benner Harper & Associates, L.L.C.
All providers in Saint Paul, MN · Orthopedic Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.