Individual ProviderJacob A. SytsmaPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address10900 73rd Ave N Ste 140, Maple Grove, MN 55369-5400(763) 315-1296(529) 924-0199PECOS EnrollmentBased on the most recent information from CMS, provider Jacob A. Sytsma does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1912613431Provider TypeIndividualFull NameSytsma, Jacob A.TitleDr.CredentialPT, DPTGenderMaleSole ProprietorYesEnumeration Date1/27/2023Last Updated4/22/2025Contact InformationPractice LocationPractice Address10900 73rd Ave N Ste 140, Maple Grove, MN 55369-5400Phone(763) 315-1296FaxUnlisted FaxMailing LocationMailing Address4801 W 81st St Ste 103, Bloomington, MN 55437-1111Phone(529) 924-0199FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense12471Minnesota