Individual provider Active NPI

Craig M Petroske

  • Physical Therapist
  • Hibbing, MN
National Provider Identifier
1972030260
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7158 Issued in MN
Practice address
1120 E 34TH St
Hibbing, MN 55746-2909
Phone
(218) 362-7100
Fax
(218) 362-7131
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 7158 MN Primary

Addresses

Primary practice location

1120 E 34TH St
Hibbing, MN 55746-2909

Mailing address

1120 E 34TH St
Hibbing, MN 55746-2909
Phone (218) 362-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170609000483 MN Practitioner - Physical Therapist in Private Practice 9436427747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choice Therapy, P.a.Group PAC ID 7618022930, 39 clinicians

Practice addresses (Care Compare)

1101 E 37TH St
Suite 20
Hibbing, MN 55746-2972
Phone (218) 440-1548

Merit-based Incentive Payment System (MIPS)

Final score
77.79 of 100Reported as group
Quality
71.6
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7158MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Therapy, P.a. Physical Therapist CurrentSince Jun 17, 2019 Accepting new patients

Locations

118 Central St W
Bagley, MN 56621
Phone (218) 694-3030

3835 Supreme Ct NW
Ste 2
Bemidji, MN 56601
Phone (218) 441-5232

1101 E 37th St
Ste 20
Hibbing, MN 55746
Phone (218) 440-1548

Organizations & group practices 1

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": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972030260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462909",
            "telephone_number": "218-362-7100",
            "fax_number": "218-362-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462909",
            "telephone_number": "218-362-7100",
            "fax_number": "218-362-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKE",
        "first_name": "CRAIG",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hibbing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.