MEDICARE: DR. MICHAEL W SIMON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8604	AZ
2	225100000X	Physical Therapist	9552	MN

General Provider Information

NPI Number	:	1811128614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL W SIMON DPT

Provider Business Mailing Address
First Line	:	7581 9TH ST N STE 100
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-6635
Country	:	US
Telephone Number	:	651-748-4338
Fax Number	:	651-748-2892

Provider Business Practice Location Address
First Line	:	601 CENTRAL AVE W STE 102
Second Line	:
City	:	SAINT MICHAEL
State	:	MN
Zip	:	55376-9711
Country	:	US
Telephone Number	:	763-595-1300
Fax Number	:	763-276-1190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	11/20/2020

Similar Medicare Providers

1568138576 — JACOB E TODD PT, DPT
Practice Location Address:

601 CENTRAL AVE W STE 102
SAINT MICHAEL, MN
55376-9711

Practice Phone: 763-595-1300
Practice Fax: 763-276-1190

1013534833 — JON FRIKKEN DPT
Practice Location Address:

601 CENTRAL AVE W STE 102
SAINT MICHAEL, MN
55376-9711

Practice Phone: 763-595-1300
Practice Fax: 763-276-1190

1720686298 — JESSICA MARIE QUAST CMT
Practice Location Address:

601 CENTRAL AVE W STE 102
SAINT MICHAEL, MN
55376-9711

Practice Phone: 763-639-6607
Practice Fax:

1396069613 — LITTLE RIVER MEDICAL CENTER, INC.
Practice Location Address:

9711 SAINT JAMES RD
MYRTLE BEACH, SC
29588-7431

Practice Phone: 843-650-8220
Practice Fax: 843-650-7909

1467383539 — CONNECTED NEURODIVERGENT SUPPORTS, LLC
Practice Location Address:

9648 51ST ST NE
SAINT MICHAEL, MN
55376-7530

Practice Phone: 310-704-1891
Practice Fax:

1760312847 — KIMBERLY LAMINE
Practice Location Address:

12070 43RD ST NE STE 200
SAINT MICHAEL, MN
55376-8427

Practice Phone: 763-515-3150
Practice Fax:

Directions to “ DR. MICHAEL W SIMON DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.