Doctor profile · Federal record
Dr. KELLY SOUKUP, PT
Physical Therapist (CMS: PHYSICAL THERAPIST IN PRIVATE PRACTICE) · BURNSVILLE, MN
- NPI 1669419610
- Accepts Medicare
- 28 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
1000 W 140TH ST, SUITE 202
BURNSVILLE, MN 553374480
(952) 808-3052
fax (952) 846-2202 - Mailing address
-
19052 INMAN TRL
LAKEVILLE, MN 550444701
Credentials & registration
- NPI registered
- May 2006 — 20 yrs on file
- Profile last updated
- April 20, 2011
- Year of graduation
- 1998 — 28 yrs since
- Specialty taxonomy
- 225100000X — NUCC code
- State license (1)
- Minnesota #7269
- Medicaid
- MN #011698000
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1669419610. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
615
Distinct HCPCS
4
Medicare allowed
$18,829
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
97110 |
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 288 | 51 | $21 | |
97112 |
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 241 | 49 | $28 | |
97162 |
Evaluation for physical therapy, typically 30 minutes | 55 | 54 | $94 | |
97530 |
Therapy procedure using functional activities | 31 | 24 | $29 |
In context: peer comparison
Among 26 peers in this city , average services per provider: 150. This provider delivers 4.1× the peer median.