DR. JORDAN RHAE LUNDBERG (DPT) – Orthopedic Physical Therapist, NPI 1114603677

DR. JORDAN RHAE LUNDBERG (DPT) is a healthcare provider. based in Duluth, Minnesota. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 13111 (MN). The NPI Number for DR. JORDAN RHAE LUNDBERG (DPT) is 1114603677

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. JORDAN RHAE LUNDBERG (DPT)
NPI
1114603677
Phone
(218) 841-7092
Address
224 W FARIBAULT ST
Enumeration Date
27 June 2023
Last Update Date
27 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528318742
Graduation Year
2023 (3 years ago)
PAC ID
6002276284
Group Practice PAC ID
3173570561
Professional Enrollment ID
I20230719003050
Address ID
MN554314420BL3800XWXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,108 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN

Provider Addresses for DR. JORDAN RHAE LUNDBERG (DPT)

  • 224 W FARIBAULT ST

    DULUTH, MN 558031729

    Phone: (218) 841-7092

    Type: Mailing

  • 2001 BLAISDELL AVE

    MINNEAPOLIS, MN 554042414

    Phone: (952) 993-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230719003050IPhysical Therapist In Private PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes5114$0
View full utilization report →

Insurance plans in this area (ZIP 55803)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173570561View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMN
-MN
Physical Medicine And RehabilitationMN
Orthopedic SurgeryMN
Occupational Therapist In Private PracticeMN
-MN
-MN
Physical Therapist In Private PracticeMN
-MN
-MN

Reviews

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Frequently asked questions

What federal number belongs to DR. JORDAN RHAE LUNDBERG (DPT)?
The federal identifier for DR. JORDAN RHAE LUNDBERG (DPT) is NPI 1114603677.
Does this profile mean DR. JORDAN RHAE LUNDBERG (DPT) is currently active?
Yes — DR. JORDAN RHAE LUNDBERG (DPT) appears active in the national provider directory.
What kind of provider is DR. JORDAN RHAE LUNDBERG (DPT)?
The page reflects Orthopedic Physical Therapist for DR. JORDAN RHAE LUNDBERG (DPT). Clinical services aligned with this taxonomy classification.
Where does public data place DR. JORDAN RHAE LUNDBERG (DPT)?
The snapshot lists Duluth, Minnesota for DR. JORDAN RHAE LUNDBERG (DPT); download NPPES for the complete set.
What if Duluth, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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