Individual provider Active NPI

Brittney Lee Braegelmann, DPT

  • Sports Physical Therapist
  • Waite Park, MN
National Provider Identifier
1942521513
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
8626 Issued in MN
Practice address
901 3Rd St N
Waite Park, MN 56387-1964
Phone
(320) 217-8480
Fax
(320) 217-8490
NPI assigned
Jun 18, 2010
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 8626 MN Primary

Addresses

Primary practice location

901 3Rd St N
Waite Park, MN 56387-1964

Mailing address

901 3Rd St N
Waite Park, MN 56387-1964
Phone (218) 786-3500

Other identifiers 1

IdentifierTypeStateIssuer
1942521513MedicaidMN

Other names 1

  • Brittney Lee Johnson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000762 MN Practitioner - Physical Therapist in Private Practice 4587835475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rejuv Medical PAGroup PAC ID 2264598077, 15 clinicians

Practice addresses (Care Compare)

901 3Rd St N
Waite Park, MN 56387-1964
Phone (320) 217-8480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuv Medical, P.a. Sports CurrentSince Apr 14, 2014 Accepting new patients
Rejuv Savage Management CurrentSince Sep 2, 2025 Accepting new patients
Medifit Health, LLC CurrentSince Apr 14, 2014 Accepting new patients

Locations

7373 France Ave S
Ste 606
Minneapolis, MN 55435
Phone (612) 207-7463

210 3rd St N
Waite Park, MN 56387
Phone (320) 281-5100

901 3rd St N
Waite Park, MN 56387
Phone (320) 217-8480

Interoperability endpoints

  • Direct secure messaging: brittney.braegelmann.1@32275.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/32275/brand/1/csg/1/fhir/r4

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1942521513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 3RD ST N",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871964",
            "telephone_number": "218-786-3500",
            "fax_number": "320-217-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 3RD ST N",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871964",
            "telephone_number": "320-217-8480",
            "fax_number": "320-217-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAEGELMANN",
        "first_name": "BRITTNEY",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MN",
            "license": "8626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942521513",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTNEY",
            "last_name": "JOHNSON",
            "middle_name": "LEE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.