Individual provider Active NPI

Kelsey Marie Danzeisen Abraham, OT

  • Occupational Therapist
  • Shakopee, MN
National Provider Identifier
1124359591
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
103835 Issued in MN
Practice address
1880 Independence Dr
Shakopee, MN 55379-2031
Phone
(952) 239-1882
NPI assigned
Jan 25, 2010
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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 103835 MN Primary

Addresses

Primary practice location

1880 Independence Dr
Shakopee, MN 55379-2031

Mailing address

1880 Independence Dr
Shakopee, MN 55379-2031
Phone (952) 239-1882

Other practice location 1

3120 N Chestnut St
Chaska, MN 55318-3063
Phone (952) 221-1532

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730002284 MN Practitioner - Occupational Therapist in Private Practice 3779090022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

3120 N Chestnut St
Chaska, MN 55318-3063
Phone (952) 221-1532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince May 28, 2025 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince May 28, 2025 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1124359591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 INDEPENDENCE DR",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792031",
            "telephone_number": "952-239-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 INDEPENDENCE DR",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792031",
            "telephone_number": "952-239-1882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 N Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553183063",
            "country_code": "US",
            "telephone_number": "952-221-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "KELSEY",
        "middle_name": "MARIE DANZEISEN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-25",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.