| Minnesota Medical And Rehabilitative Services, Llc | |
|
4201 Excelsior Blvd, St. Louis Park, MN 55416-4728 | |
| (952) 564-3880 | |
| (952) 945-9536 |
| Full Name | Minnesota Medical And Rehabilitative Services, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 4201 Excelsior Blvd, St. Louis Park, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154302545 | NPI | - | NPPES |
| 407858600 | Medicaid | MN | |
| 1154302545 | Medicaid | MN |
| Provider Name | Lawrence W Biel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508818824 PECOS PAC ID: 6204810625 Enrollment ID: I20040615000207 |
| Provider Name | Ellen Garbo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043265689 PECOS PAC ID: 9537126958 Enrollment ID: I20041216000556 |
| Provider Name | Scott M Ross |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1417944349 PECOS PAC ID: 6608852876 Enrollment ID: I20050108000056 |
| Provider Name | Jill M Gray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124124045 PECOS PAC ID: 5799727095 Enrollment ID: I20050526000515 |
| Provider Name | Bettejane K Goldman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528211836 PECOS PAC ID: 0042254427 Enrollment ID: I20050616000380 |
| Provider Name | Raisa Gringauz |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1396905212 PECOS PAC ID: 8224061742 Enrollment ID: I20050915000300 |
| Provider Name | Scott D Wagner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982648051 PECOS PAC ID: 0244332062 Enrollment ID: I20070226000509 |
| Provider Name | Jacob I Mirman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568404440 PECOS PAC ID: 9537263058 Enrollment ID: I20070322000334 |
| Provider Name | Nina R Bacaner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578576021 PECOS PAC ID: 8628153889 Enrollment ID: I20080312000100 |
| Provider Name | Constantin Nicolaevich Starchook |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1942251822 PECOS PAC ID: 7810030673 Enrollment ID: I20100203000055 |
| Provider Name | Jack Lm Mutnick |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1487601316 PECOS PAC ID: 1658400866 Enrollment ID: I20100526001002 |
| Provider Name | Cole Anthony Buchtel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811281645 PECOS PAC ID: 4688938244 Enrollment ID: I20180507001447 |
| Provider Name | Sarah Anne Frid |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1538766324 PECOS PAC ID: 9133539497 Enrollment ID: I20201028000857 |
| Provider Name | Taran John Barrett |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285205351 PECOS PAC ID: 7416353818 Enrollment ID: I20210910000318 |
| Provider Name | Mai Ko Xiong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033986534 PECOS PAC ID: 1850744665 Enrollment ID: I20240129001833 |
| Provider Name | Akhsa Simonovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003599614 PECOS PAC ID: 0244675072 Enrollment ID: I20240301003056 |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Medical And Rehabilitative Services, Llc 4201 Excelsior Blvd, St. Louis Park, MN 55416-4728 Ph: (952) 564-3880 | Minnesota Medical And Rehabilitative Services, Llc 4201 Excelsior Blvd, St. Louis Park, MN 55416-4728 Ph: (952) 564-3880 |
Mr. James Joseph Brenny, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2257 Louisana Avenue South, St. Louis Park, MN 55426 Phone: 952-848-0935 | |
Kamaria Linn Schmidt, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4415 West 36 1/2 St, St. Louis Park, MN 55416 Phone: 952-927-9717 Fax: 952-927-7687 | |
Kay Elizabeth Lichtenberger, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4415 W 36.5 St, St. Louis Park, MN 55416 Phone: 952-927-7687 | |
Mrs. Stacey A. Neville, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4415 West 36 1/2 Street, St. Louis Park, MN 55416 Phone: 952-927-9717 Fax: 952-927-7687 | |
Mrs. Julia Louise Sands, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 6500 Excelsior Blvd., Methodist Hospital, St. Louis Park, MN 55426 Phone: 952-993-0712 Fax: 952-993-0035 | |
Dr. Michelle A Ugalde, PT-DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1660 Highway 100 South, Suite 145, St. Louis Park, MN 55416 Phone: 952-456-6160 Fax: 952-456-6184 |