Active NPI
Madelin Roberts, OTR/L
- Occupational Therapist
- Waconia, MN
National Provider Identifier
1093365769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 106049
- Practice address
- 9346 Oak Ave
Waconia, MN 55387-9422 - Phone
- (952) 223-2506
- NPI assigned
- Sep 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 106049 | MN | Primary |
Addresses
Primary practice location
9346 Oak Ave
Waconia, MN 55387-9422
Mailing address
9346 Oak Ave
Waconia, MN 55387-9422
Phone (529) 223-2506
Other practice location 1
5868 Baker Rd
Minnetonka, MN 55345-5903
Phone (952) 767-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106049 | MN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunnydays Therapy Inc | Occupational Therapist | Current | Accepting new patients |
Locations
9346 Oak Ave
Waconia, MN 55387
Phone (952) 442-5812
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.
-
- Occupational Therapist
- Waconia, MN
- NPI 1891914412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1093365769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9346 OAK AVE",
"city": "WACONIA",
"state": "MN",
"postal_code": "553879422",
"telephone_number": "529-223-2506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9346 OAK AVE",
"city": "WACONIA",
"state": "MN",
"postal_code": "553879422",
"telephone_number": "952-223-2506"
}
],
"practiceLocations": [
{
"address_1": "5868 Baker Rd",
"address_purpose": "LOCATION",
"city": "Minnetonka",
"state": "MN",
"postal_code": "553455903",
"country_code": "US",
"telephone_number": "952-767-4200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "MADELIN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-16",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "106049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.