Individual provider Active NPI

Meredith Eve Hoerske, OTR/L

  • Occupational Therapist
  • Boulder, CO
National Provider Identifier
1043325913
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1866 Issued in CO
Practice address
2108 55TH St Ste 130
Boulder, CO 80301-2827
Phone
(720) 760-3222
Fax
(720) 664-6504
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1866 CO Primary

Addresses

Primary practice location

2108 55TH St Ste 130
Boulder, CO 80301-2827

Mailing address

555 Manhattan Dr Unit 203
Boulder, CO 80303-4079
Phone (303) 931-5445

Other identifiers 2

IdentifierTypeStateIssuer
OT10327OtherFLLICENSE #
OT.0001866OtherCOCO STATE LICENSE

Other names 1

  • Meredith Sullivan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000446 CO Practitioner - Occupational Therapist in Private Practice 9931384310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2108 55TH St
Suite 130
Boulder, CO 80301-2827
Phone (720) 760-3222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1866COMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Front Range Upper Extremity Rehab, LLC Occupational Therapist CurrentSince Mar 1, 2020 Accepting new patients

Locations

2108 55th St
Ste 130
Boulder, CO 80301
Phone (720) 363-0139

3775 Iris Ave
Ste 2AB
Boulder, CO 80301
Phone (813) 431-3702

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1043325913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MANHATTAN DR UNIT 203",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034079",
            "telephone_number": "303-931-5445",
            "fax_number": "720-664-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 55TH ST STE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012827",
            "telephone_number": "720-760-3222",
            "fax_number": "720-664-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOERSKE",
        "first_name": "MEREDITH",
        "middle_name": "EVE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "1866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "OT10327",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO STATE LICENSE",
            "identifier": "OT.0001866",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "SULLIVAN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.