Individual provider Active NPI

Peter J Bzdusek, PT

  • Physical Therapist
  • Minneapolis, MN
National Provider Identifier
1992800544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7692 Issued in MN
Practice address
2450 Riverside Ave
Suite R102
Minneapolis, MN 55454-1450
Phone
(612) 273-9400
NPI assigned
Sep 14, 2006
Sex
Male
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 7692 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
Suite R102
Minneapolis, MN 55454-1450

Mailing address

110 W Grant St
#6K
Minneapolis, MN 55403-2309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061215000214 MN Practitioner - Physical Therapist in Private Practice 5496754624 Reassigns benefits to 2 organizations

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
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2525 University Ave SE
Minneapolis, MN 55414-3205
Phone (612) 672-6697

2535 University Ave SE
Minneapolis, MN 55414-3205
Phone (612) 672-2350

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

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

State licenses

LicenseStateTypeSpecialty
7692MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Oct 1, 2006 Accepting new patients
Fairview Express Care CurrentSince Feb 13, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Feb 13, 2021 Accepting new patients

Locations

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

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

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

2450 Riverside Ave
Ste R102
Minneapolis, MN 55454
Phone (612) 273-7100

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

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

Organizations & group practices 6

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992800544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W GRANT ST",
            "address_2": "#6K",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "SUITE R102",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-273-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BZDUSEK",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7692",
            "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.