Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan Rekedal, DPT

Individual provider Physical Therapist · NPI 1821961541

Ethan Rekedal, DPT is an Undefined Non-Physician Type (Specify) in Lakeville, Minnesota. Qualified in 2025, 1 year ago. Practices with Summit Orthopedics, Ltd, a 280-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

17210 Kenyon Ave
Lakeville, MN 55044-6903
Phone: (651) 968-5201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1821961541
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 29, 2025
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 28, 2025
Mailing address17210 Kenyon Ave, Lakeville, MN 55044-6903

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Summit Orthopedics, Ltd — 280 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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