Active NPI
Samuel Bornhorst, OTR
- Occupational Therapist
- Edina, MN
National Provider Identifier
1144071879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 102766
- Practice address
- 3400 W 66TH St Ste 240
Edina, MN 55435-2100 - Phone
- (952) 857-0304
- NPI assigned
- Mar 29, 2024
- Last updated
- Jun 10, 2026
- Sex
- Male
- 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 | 102766 | MN | Primary |
Addresses
Primary practice location
3400 W 66TH St Ste 240
Edina, MN 55435-2100
Mailing address
3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260617000324 | MN | Practitioner - Occupational Therapist in Private Practice | 2163994542 |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
13 Guy CT
Rockville, MD 20850-3148
3500 American Blvd W
Suite 300
Bloomington, MN 55431-4442
PO Box
Suite 9188
Minneapolis, MN 55480
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10115 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1144071879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 AMERICAN BLVD W STE 300",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314442",
"telephone_number": "952-512-5600",
"fax_number": "952-512-5651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 W 66TH ST STE 240",
"city": "EDINA",
"state": "MN",
"postal_code": "554352100",
"telephone_number": "952-857-0304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORNHORST",
"first_name": "SAMUEL",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-29",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "102766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
- Bridgett Ann Bonte-Chun, DPT
- Chris Peter Boosalis, CERTIFIED PROSTHETIS
- Julie Edith Borgen, HIS
- Tove Nikol Borgendale-Potchinsky, TOVE BORGENDALE
- Hannah Christine Rikkers Borkhus, MA, LPCC
- Adena Fern Borodkin, DDS
- Margaret Bostrom, CRNA
- Sarah Teresa Bot, PHYSICIAN ASSISTANT
- Both& Counseling PLLC
- David Botros, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.