JOHN A GERGEN (PT, MBA) – Physical Therapist, NPI 1619926912

JOHN A GERGEN (PT, MBA) is a healthcare provider. based in Andover, Minnesota. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, MBA. They hold a License No. 5477 (MN). The NPI Number for JOHN A GERGEN (PT, MBA) is 1619926912

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
JOHN A GERGEN (PT, MBA)
NPI
1619926912
Phone
(763) 221-1424
Address
15856 LINNET ST NW
Enumeration Date
6 May 2006
Last Update Date
14 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8004446845
Graduation Year
1992 (34 years ago)
PAC ID
1052210648
Group Practice PAC ID
5193036432
Professional Enrollment ID
I20040102000435
Address ID
MN554325106FR6490XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:20State licenses:1Digital endpointsOther names

2,108 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN

Provider Addresses for JOHN A GERGEN (PT, MBA)

  • 15856 LINNET ST NW

    ANDOVER, MN 553042686

    Phone: (763) 221-1424

    Type: Mailing

  • 19131 TAYLOR ST NE

    EAST BETHEL, MN 550114422

    Phone: (763) 392-5443

    Type: Location

  • 124th Avenue NW, Coon Rapids, Anoka County, Minnesota, 55433, United States

    SUITE 100

    COON RAPIDS, MN 554334572

    Phone: (763) 236-8911

    Fax: (763) 236-8930

    Type: Location

  • 715, Ione Avenue Northeast, Spring Lake Park, Anoka County, Minnesota, 55432, United States

    SPRING LAKE PARK, MN 554321240

    Phone: (763) 783-3552

    Type: Mailing

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: 2004-01-02

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
I20040102000435IPhysical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55304)

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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: 5193036432View full group profile
NameSpecialtyState
-MO
-AL
-IL
Qualified Speech Language PathologistFL
-MO
Occupational Therapist In Private PracticeUT
Physical Therapist In Private PracticeWI
-WI
-WI
-FL

Reviews

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Frequently asked questions

What federal number belongs to JOHN A GERGEN (PT, MBA)?
The federal identifier for JOHN A GERGEN (PT, MBA) is NPI 1619926912.
Is JOHN A GERGEN (PT, MBA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does JOHN A GERGEN (PT, MBA) list a primary specialty?
If you are matching referrals, note Physical Therapist for JOHN A GERGEN (PT, MBA). Clinical services aligned with this taxonomy classification.
Where does public data place JOHN A GERGEN (PT, MBA)?
The snapshot lists Andover, Minnesota for JOHN A GERGEN (PT, MBA); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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