Individual provider Active NPI

McKenzie Marie Koch, OTD, OTR/L

  • Occupational Therapist
  • Lake City, MN
National Provider Identifier
1295626208
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107540 Issued in MN
Practice address
500 W Grant St
Lake City, MN 55041-1143
Phone
(507) 377-6285
NPI assigned
Jul 9, 2025
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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 107540 MN Primary

Addresses

Primary practice location

500 W Grant St
Lake City, MN 55041-1143

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcota2247078@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260213002228 MN Practitioner - Occupational Therapist in Private Practice 5991285561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Minneapolis, MN 55486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107540MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 8, 2026 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jan 8, 2026 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 8, 2026 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: mcota2247078@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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 Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1295626208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W GRANT ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411143",
            "telephone_number": "507-377-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "MCKENZIE",
        "middle_name": "MARIE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcota2247078@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "500 W Grant St",
            "city": "Lake City",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550411143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.