Individual provider Active NPI

Megan Colette Smisek Holey, OTR/L

  • Occupational Therapist
  • Burnsville, MN
National Provider Identifier
1063972396
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
105936 Issued in MN
Practice address
150 Cobblestone LN
Burnsville, MN 55337-4578
Phone
(952) 460-4923
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 105936 MN Primary

Addresses

Primary practice location

150 Cobblestone LN
Burnsville, MN 55337-4578

Mailing address

150 Cobblestone LN
Burnsville, MN 55337-4578
Phone (952) 460-4923

Other practice location 1

14301 Ewing Ave S
Burnsville, MN 55306-4885
Phone (952) 746-5350

Other practice location 2

7624 Executive Dr
Eden Prairie, MN 55344-3677
Phone (952) 944-0240

Other names 1

  • Megan Colette Smisek Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190424001413 MN Practitioner - Occupational Therapist in Private Practice 7719229699 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105936MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy for Me Inc CurrentSince Sep 24, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Aug 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Aug 1, 2024 Accepting new patients
Therapy for Me CurrentSince Sep 24, 2023 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

7624 Executive Dr
Eden Prairie, MN 55344
Phone (952) 944-0240

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

Organizations & group practices 6

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1063972396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 COBBLESTONE LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374578",
            "telephone_number": "952-460-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 COBBLESTONE LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374578",
            "telephone_number": "952-460-4923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14301 Ewing Ave S",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553064885",
            "country_code": "US",
            "telephone_number": "952-746-5350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7624 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553443677",
            "country_code": "US",
            "telephone_number": "952-944-0240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLEY",
        "first_name": "MEGAN",
        "middle_name": "COLETTE SMISEK",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "SMISEK",
            "middle_name": "COLETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.