Mikael Anghelo Viazcan Olvera, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

502715 Issued in MN

Practice address

5200 Oak Grove Pkwy N
Brooklyn Park, MN 55443-4031

Phone

(763) 531-5039

NPI assigned

Jul 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Rehab LLCGroup PAC ID 9032351192, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Ascend Rehab, LLC

  • Physical Therapy Clinic/Center
  • St Louis Park, MN
  • NPI 1437403110
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1265278766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 OAK GROVE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434031",
            "telephone_number": "763-531-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIAZCAN OLVERA",
        "first_name": "MIKAEL",
        "middle_name": "ANGHELO",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "502715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Panhia Vang, APRN
• Kira Varner, LPN
• Jose Anthony Vasquez
• Nicholas David Vasquez
• Vent LLC
• Victory Home Care, Inc
• Victory Homes LLC
• Viko Health Services
• Laura Bree Villaverde, LMFT
• Virtue Home Health Care LLC

• Occupational Therapist in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.