Charles Broback, DPT, CSCS
NPI 1154939171ActiveIndividual· Physical Therapist· Golden Valley, MN
Physical Therapist (DPT, CSCS) in Golden Valley, Minnesota, licensed in MN, with an NPI issued in July 2020.
Overview
| NPI | 1154939171 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT, CSCS |
| Sole proprietor | No |
| NPI issued | Jul 15, 2020 |
| Last updated in NPPES | Jul 21, 2020 |
| Certified by provider | Jul 21, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 11910 | MN |
| Physical Therapist, Sports | 2251S0007X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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