Individual provider Active NPI

Madisen Lynn Prasek, OTD, OTR/L

  • Occupational Therapist
  • Pleasant Hill, IA
National Provider Identifier
1174356059
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
125681 Issued in IA
Practice address
5800 NE 12TH Ave
Pleasant Hill, IA 50327-8801
Phone
(515) 265-5348
NPI assigned
Aug 26, 2024
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 125681 IA Primary

Addresses

Primary practice location

5800 NE 12TH Ave
Pleasant Hill, IA 50327-8801

Mailing address

355 88TH St Unit 2205
West Des Moines, IA 50266-7003
Phone (701) 269-2103

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014004724 IA Practitioner - Occupational Therapist in Private Practice 8325570427 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Stone Therapy Inc. CurrentSince Jul 22, 2024 Accepting new patients

Locations

2830 100th St
Ste 100
Urbandale, IA 50322
Phone (515) 537-4770

4319 NW Urbandale Dr
Urbandale, IA 50322
Phone (515) 875-9470

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, 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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1174356059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 88TH ST UNIT 2205",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667003",
            "telephone_number": "701-269-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 NE 12TH AVE",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503278801",
            "telephone_number": "515-265-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASEK",
        "first_name": "MADISEN",
        "middle_name": "LYNN",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "125681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.