Benjamin Luke Andre, DPT
Individual provider Active NPI Physical Therapist · Forest Lake, MN
NPI 1972180271 · NPPES record last updated Jun 12, 2023
Key facts
- NPI
- 1972180271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11907 (MN)
- Practice address
- 1398 Lake St S Ste 100
Forest Lake, MN 55025-2720 - Phone
- (651) 275-2700
- Fax
- (651) 309-0000
- NPI assigned
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Infinite Health Collaborative, PA
Practice addresses (Care Compare)
1398 Lake St S
Suite 100
Forest Lake, MN 55025-2720
Phone (651) 275-2700
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.79 of 100
- Quality
- 95.08
- Improvement activities
- 40
- Cost
- 81.67
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230713000627 | MN | Practitioner - Physical Therapist in Private Practice | 8426458498 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11907 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinite Health Collaborative, PA | Current |
Accepting new patients | |
| Infinite Health Collaborative, PA | Physical Therapist | Current |
Accepting new patients |
Locations
1398 Lake St S
Ste 100
Forest Lake, MN 55025
Phone (651) 275-2700
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11907 | MN | Yes |
| Physical Therapist | 225100000X | 15398-24 | WI |
Addresses
Primary practice location
1398 Lake St S Ste 100
Forest Lake, MN 55025-2720
Mailing address
4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600
Other providers in Forest Lake, MN
- Amy Anderson
- David Michael Anderson
- Kathryn A Anderson
- Stacia R Anderson
- Taryn Anderson
- Laura Lee Arcand
- Wendy Kay Arend
- Brian J Arnold
- Erin Michelle Arnold
- Linda Wilkes Asadourian
All providers in Forest Lake, MN · 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 Jun 12, 2023. 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.