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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TAYLOR J FREETLY MD
NPI 1104446996
Orthopaedic Surgery - Sports Medicine in Blaine, MN

Active since April 21, 2020PECOS Enrolled
11225 ULYSSES ST NE, BLAINE, MN 55434(763) 302-2600(763) 302-2601 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 29, 2026, Jun 30, 2025, Apr 21, 2020 (3 updates tracked since 2020).

About Dr. Taylor J Freetly Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TAYLOR J FREETLY MD (NPI 1104446996) is an individual sports medicine provider in Blaine, Minnesota, licensed in Minnesota (79997) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of State University Of Ny Upstate Medical University (2020).

NPPES Registry Identity

NPI1104446996
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameDR. TAYLOR J FREETLYCredential: MD
Location Address11225 ULYSSES ST NEBlaine, MN 55434-4261
Mailing Address3500 American Blvd W Ste 300Bloomington, MN 55431-4442 · (952) 512-5600
Phone(763) 302-2600
Fax(763) 302-2601
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2020
Enumeration DateApril 21, 2020
Last NPPES UpdateJuly 29, 20263 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1104446996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in MN · 79997
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 79997 (MN)
11225 ULYSSES ST NE, Blaine, MN 55434
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Taylor J Freetly Md 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.

PECOS PAC ID3971929167
PECOS Enrollment IDI20250709002669
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMUEL JOHN ARNOLD DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
HANNAH MARIE MARTIN DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
SARAH J JENKS DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
ELIZA S DAHLY PA-C
Physician Assistant
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
ALEXIS HYDUKOVICH DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
KACI MARIE TRACZYK PT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
MARY A KOCH PT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
ASHLEY K GANSER PA-C
Physician Assistant
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600

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 Taylor Freetly's NPI number?

The NPI number for Taylor Freetly is 1104446996. It was assigned to this individual provider in the NPPES registry on April 21, 2020.

Where is Taylor Freetly located?

Taylor Freetly practices at 11225 Ulysses St NE, Blaine, MN 55434. The listed phone number is (763) 302-2600.

What is Taylor Freetly's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Taylor Freetly enrolled in Medicare?

Yes. Taylor Freetly 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.

What insurance does Taylor Freetly accept?

Health plans from HealthPartners and Medica list Taylor Freetly 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 Taylor Freetly was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.