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Minnesota Medical and Rehabilitative Services, LLC

Physical Therapist in St. Louis Park, MN · enumerated 2005 · authorized official Jacob Mirman, Managing Partner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1154302545

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Registry record

Entity type Organization (Type 2)
Legal business name Minnesota Medical and Rehabilitative Services, LLC
Practice address 4201 Excelsior Blvd, St. Louis Park, MN, 55416
Phone (952) 564-3880
Fax (952) 945-9536
Enumeration date Nov 11, 2005
Last updated in NPPES Sep 18, 2025

Taxonomy & classification

225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 1544 (MN) Primary
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 5806 (MN) Secondary
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 2264 (MN) Secondary
225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 102980 (MN) Secondary
235Z00000X Speech-Language Pathologist Speech, Language and Hearing Service Providers · License 5169 (MN) Secondary
235Z00000X Speech-Language Pathologist Speech, Language and Hearing Service Providers · License 6034 (MN) Secondary

Authorized official

Name Jacob Mirman
Title Managing Partner
Phone (952) 933-8900

Other identifiers

Identifier Type State Issuer
407858600 Medicaid MN -
1154302545 Medicaid MN -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-09-18. Verify at npiregistry.cms.hhs.gov.
Where is Minnesota Medical and Rehabilitative Services, LLC located?
The practice location on file with NPPES is in St. Louis Park, MN.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-18.