Individual provider Active NPI

Adrian Jung

  • Occupational Therapist
  • Woodbury, MN
National Provider Identifier
1285087072
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC014595 Issued in PA
Practice address
155 Radio Drive
Woodbury, MN 55125
Phone
(952) 831-8742
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 OC014595 PA Primary

Addresses

Primary practice location

155 Radio Drive
Woodbury, MN 55125

Mailing address

8100 Northland Dr
Bloomington, MN 55431-4800

Other practice location 1

2775 Schoenersville Rd
Bethlehem, PA 18017-7307
Phone (610) 861-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161122000567 CT Practitioner - Occupational Therapist in Private Practice 5799072492
I20170819000099 MN Practitioner - Occupational Therapist in Private Practice 5799072492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

155 Radio Dr
Woodbury, MN 55125-2619
Phone (952) 831-8742

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tria Orthopaedic Center LLC CurrentSince Aug 14, 2017 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Clinic CurrentSince May 1, 2023 Accepting new patients

Locations

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

155 Radio Dr
Woodbury, MN 55125
Phone (952) 883-6212

Organizations & group practices 3

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285087072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 NORTHLAND DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 RADIO DRIVE",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2775 Schoenersville Rd",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180177307",
            "country_code": "US",
            "telephone_number": "610-861-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "ADRIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC014595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.