DR. JONATHAN GOGOLAKIS DPT
NPI 1770319675
Physical Therapist in Maple Grove, MN
About Dr. Jonathan Gogolakis Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JONATHAN GOGOLAKIS DPT (NPI 1770319675) is an individual physical therapist in Maple Grove, Minnesota, licensed in Minnesota (13666) and active in the NPI registry since September 2024.
NPPES Registry Identity
Specialties & Licenses
- 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.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jonathan Gogolakis Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jonathan Gogolakis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Eden Prairie, MN 55344
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Odom Sports Medicine PA
- 92 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.
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 Jonathan Gogolakis's NPI number?
The NPI number for Jonathan Gogolakis is 1770319675. It was assigned to this individual provider in the NPPES registry on September 9, 2024.
Where is Jonathan Gogolakis located?
Jonathan Gogolakis practices at 9505 Blackoaks Ln N, Maple Grove, MN 55311. The listed phone number is (763) 420-4111.
What is Jonathan Gogolakis's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Jonathan Gogolakis enrolled in Medicare?
Yes. Jonathan Gogolakis is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jonathan Gogolakis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Gogolakis reassigns Medicare benefits to Odom Sports Medicine, P.A. (Eden Prairie, 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 Jonathan Gogolakis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jonathan Gogolakis was last updated on September 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.