Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Center for Primary Care and Rehabilitation, PA

Organization Rehabilitation Practitioner · NPI 1780963355

Center for Primary Care and Rehabilitation, PA provides Rehabilitation Practitioner services in Eagan, Minnesota. Licensed in Minnesota. Registered with an NPI since 2011.

Licensed in
MN
In the registry since
2011
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

880 Blue Gentian Rd Ste 165
Eagan, MN 55121-1772 Not confirmed with CMS for 15 years — call before visiting
Phone: (651) 789-8022
Fax: (651) 789-8028
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X · Licence 45600 (MN)

Record details

NPI number1780963355
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elena Polukhin — Owner/Medical Director · (651) 789-8022
NPI enumeratedAugust 12, 2011
Last updated in NPPESAugust 12, 2011
Mailing address3006 Frank St, Maplewood, MN 55109-5501

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