Individual provider Active NPI

Emenet Sime

  • Occupational Therapist
  • Eden Prairie, MN
National Provider Identifier
1265285282
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
349017 Issued in MN
Practice address
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone
(612) 364-1901
NPI assigned
Apr 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 349017 MN Primary

Addresses

Primary practice location

6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356

Mailing address

6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone (612) 364-1901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419002367 MN Practitioner - Occupational Therapist in Private Practice 9537508775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Odom Sports Medicine PAGroup PAC ID 0143485607, 63 clinicians

Practice addresses (Care Compare)

6545 Flying Cloud Dr
Suite 201
Eden Prairie, MN 55344-3356
Phone (952) 224-1919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
349017MNMDOccupational Therapist
6078MNMDPrimary Care Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1265285282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FLYING CLOUD DR STE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443356",
            "telephone_number": "612-364-1901",
            "fax_number": "763-710-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FLYING CLOUD DR STE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443356",
            "telephone_number": "612-364-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIME",
        "first_name": "EMENET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "349017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.