Active NPI
Andrea Tesarek, OTR/L
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1235774969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2389
- Practice address
- 12020 Pacific St
Omaha, NE 68154-3507 - Phone
- (800) 259-9897
- NPI assigned
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 104984 | IA | |
| Occupational Therapist | 225X00000X | 5201011300 | MI | |
| Occupational Therapist | 225X00000X | 2389 | NE | Primary |
Addresses
Primary practice location
12020 Pacific St
Omaha, NE 68154-3507
Mailing address
12020 Pacific St
Omaha, NE 68154-3507
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 |
|---|---|---|---|
| 2389 | NE | MD | Family Medicine Physician |
| 104984 | IA | MD | Occupational Therapist |
| 5201011300 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1235774969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12020 PACIFIC ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681543507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12020 PACIFIC ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681543507",
"telephone_number": "800-259-9897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESAREK",
"first_name": "ANDREA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "104984",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201011300",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.