Active NPI
Derek Techam, OTR/L
- Occupational Therapist
- Saint Paul, MN
National Provider Identifier
1306792247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 108055
- Practice address
- 1394 Jackson St
Saint Paul, MN 55117-4629 - Phone
- (651) 603-8774
- NPI assigned
- Mar 4, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 108055 | MN | Primary |
Addresses
Primary practice location
1394 Jackson St
Saint Paul, MN 55117-4629
Mailing address
1394 Jackson St
Saint Paul, MN 55117-4629
Phone (651) 603-8774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4400 Lange Ave NE
Saint Michael, MN 55376-9556
Phone (763) 777-9445
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108055 | MN | MD | Occupational Therapist |
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": "1772582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1306792247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1394 JACKSON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551174629",
"telephone_number": "651-603-8774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1394 JACKSON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551174629",
"telephone_number": "651-603-8774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TECHAM",
"first_name": "DEREK",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-04",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "108055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.