HAILEY PHOULAVAN DPT
NPI 1245111947
Physical Therapist in West St Paul, MN

Active since September 09, 2025
60 MARIE AVE E STE 203, WEST ST PAUL, MN 55118(651) 451-6156(651) 451-0387 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Hailey Phoulavan Dpt NPPES

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

HAILEY PHOULAVAN DPT (NPI 1245111947) is an individual physical therapist in West St Paul, Minnesota, licensed in Minnesota (14100) and active in the NPI registry since September 2025. The provider is a graduate of Other (2025).

NPPES Registry Identity

NPI1245111947
Entity TypeIndividual
Primary Taxonomy225100000X
Provider Legal NameHAILEY PHOULAVANCredential: DPT
Location Address60 MARIE AVE E STE 203West St Paul, MN 55118-5932
Mailing Address897 Redwell LnApple Valley, MN 55124-8943 · (612) 709-1395
Fax(651) 451-0387
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 9, 2025
NPPES CertifiedSeptember 9, 2025
✔ NPI 1245111947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in MN · 14100
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
60 MARIE AVE E STE 203, West St Paul, MN 55118

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hailey Phoulavan Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9830672971
PECOS Enrollment IDI20260317001142

Medicare Billing Reassignment

Medicare enrollment records show Hailey Phoulavan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Rehabilitation
6025 LAKE RD STE 200
Woodbury, MN 55125
  • Reassigned Medicare billing, Minnesota enrollment
  • 89 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 3

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

Physical Therapist
60 MARIE AVE E STE 203
WEST ST PAUL, MN 55118
Physical Therapist
60 MARIE AVE E STE 203
WEST ST PAUL, MN 55118
Physical Therapist
60 MARIE AVE E STE 203
WEST ST PAUL, MN 55118

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 Hailey Phoulavan's NPI number?

The NPI number for Hailey Phoulavan is 1245111947. It was assigned to this individual provider in the NPPES registry on September 9, 2025.

Where is Hailey Phoulavan located?

Hailey Phoulavan practices at 60 Marie Ave E Ste 203, West St Paul, MN 55118. The listed phone number is (651) 451-6156.

What is Hailey Phoulavan's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Hailey Phoulavan enrolled in Medicare?

Yes. Hailey Phoulavan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Hailey Phoulavan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hailey Phoulavan reassigns Medicare benefits to Novacare Outpatient Rehabilitation East, Inc. (Woodbury, 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 Hailey Phoulavan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hailey Phoulavan accept?

Health plans from Medica list Hailey Phoulavan 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 Hailey Phoulavan was last updated on September 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.