Mattie Lee Anheluk, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103472 Issued in MN

Practice address

333 Smith Ave N
Saint Paul, MN 55102-2344

Phone

(651) 241-5488

Fax

(651) 241-7177

NPI assigned

Apr 2, 2008

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: manheluk65209@excellian.direct.allina.com

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 1083910871

  • NPI 1083910871
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1225200934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ABBOTT NORTHWESTERN HOSPITAL",
            "address_2": "800 E 28TH STREET",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073799",
            "telephone_number": "612-562-2945",
            "fax_number": "126-863-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-5488",
            "fax_number": "651-241-7177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Abbott Northwestern Hospital",
            "address_2": "800 E 28th Street",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073799",
            "country_code": "US",
            "telephone_number": "126-863-7642",
            "fax_number": "126-863-8942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANHELUK",
        "first_name": "MATTIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2022-01-03",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT PRACTICTIONER LICENSE",
            "identifier": "103472",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.