THOMAS BROBACK DPT, CSCS
NPI 1063930493
Physical Therapist - Orthopedic in Stillwater, MN
About Thomas Broback Dpt, Cscs NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THOMAS BROBACK DPT, CSCS (NPI 1063930493) is an individual orthopedic provider in Stillwater, Minnesota, licensed in Minnesota (10800) and active in the NPI registry since September 2017. He is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Thomas Broback Dpt, Cscs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Thomas Broback reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lakeville, MN 55044
- Reassigned Medicare billing, Minnesota enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Thomas Broback's NPI number?
The NPI number for Thomas Broback is 1063930493. It was assigned to this individual provider in the NPPES registry on September 6, 2017.
Where is Thomas Broback located?
Thomas Broback practices at 14382 60th St N, Stillwater, MN 55082. The listed phone number is (651) 342-0509.
What is Thomas Broback's specialty?
The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.
Is Thomas Broback enrolled in Medicare?
Yes. Thomas Broback is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Thomas Broback's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Broback reassigns Medicare benefits to Pink Skies Corporation (Lakeville, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Broback's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Thomas Broback accept?
Health plans from Medica list Thomas Broback as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Thomas Broback was last updated on February 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Thomas Broback, DPT, CSCS · NPI 1063930493
Orthopedic provider in Stillwater, Minnesota. Individual provider, active in the CMS NPPES registry since September 6, 2017.
## Identity
- **NPI:** 1063930493 (Entity type: Individual)
- **Enumerated:** September 6, 2017
- **Primary specialty:** Physical Therapist - Orthopedic · taxonomy 2251X0800X
- **State license:** 10800 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 14382 60TH ST N, Stillwater, MN 55082-6311
- **Phone:** (651) 342-0509
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Pink Skies Corporation (NPI 1871294538, Lakeville, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** February 20, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1063930493) · Data from the CMS NPPES public registry.