Individual provider Active NPI

Tara D Johnson, PT

  • Physical Therapist
  • Minneapolis, MN
National Provider Identifier
1952492464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6024 Issued in MN
Practice address
650 Taft St NE
Minneapolis, MN 55413-2832
Phone
(612) 331-1815
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6024 MN Primary

Addresses

Primary practice location

650 Taft St NE
Minneapolis, MN 55413-2832

Mailing address

4201 Alabama Ave S
St Louis Park, MN 55416-3104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060309000240 MN Practitioner - Physical Therapist in Private Practice 9032126412 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
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)

14101 Fairview Dr
Suite 300
Burnsville, MN 55337-2537
Phone (952) 460-4900

3033 Excelsior Blvd
Suite 225
Minneapolis, MN 55416-0026
Phone (612) 821-4375

3305 Central Park Village Dr
Eagan, MN 55121-7707

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

800 Prairie Ctr Dr
Suite 230
Eden Prairie, MN 55344-7308
Phone (952) 944-5314

8301 Golden Valley Rd
Suite 202
Golden Valley, MN 55427-4475
Phone (763) 533-0541

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Sep 1, 2000 Accepting new patients
Healtheast Outpatient Services, LLC Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Sep 1, 2000 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients

Locations

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

1750 105th Ave NE
Blaine, MN 55449
Phone (763) 780-0356

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

6341 University Ave NE
Ste 104
Fridley, MN 55432
Phone (763) 572-4946

8301 Golden Valley Rd
Ste 202
Golden Valley, MN 55427
Phone (763) 257-1114

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

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

10961 Club West Pkwy
Ste 200
Minneapolis, MN 55449
Phone (763) 528-2922

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

3033 Excelsior Blvd
Ste 225
Minneapolis, MN 55416
Phone (612) 672-7000

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

600 W 98th St
Ste 390
Minneapolis, MN 55420
Phone (952) 460-4900

9220 Bass Lake Rd
Ste 260
New Hope, MN 55428
Phone (763) 533-0363

2600 39th Ave NE
Ste 220
Saint Anthony, MN 55421
Phone (612) 672-7100

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

9680 Tamarack Rd
Ste 130
Woodbury, MN 55125
Phone (612) 273-1172

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 9

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952492464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ALABAMA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 TAFT ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132832",
            "telephone_number": "612-331-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TARA",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.