Active NPI
Angela Kezar
- Occupational Therapist
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 105115
- Practice address
- 435 Phalen Blvd
Saint Paul, MN 55130-5302 - Phone
- (651) 254-3200
- NPI assigned
- Aug 11, 2016
- Sex
- Female
- 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 | 105115 | MN | Primary |
Addresses
Primary practice location
435 Phalen Blvd
Saint Paul, MN 55130-5302
Mailing address
814 River LN
Anoka, MN 55303-2807
Phone (763) 567-0219
Other practice location 1
1710 Suburban Ave
Saint Paul, MN 55106-6636
Phone (651) 254-3200
Other practice location 2
640 Jackson St
Rehabilitation Institute
Saint Paul, MN 55101-2502
Phone (651) 254-2097
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105115 | MN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regions Hospital | Current | Accepting new patients | |
| Regions Hospital | Current | Accepting new patients | |
| Regions Hospital | Current | Accepting new patients |
Locations
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200
640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164
1710 Suburban Ave
Saint Paul, MN 55106
Phone (651) 254-3200
Organizations & group practices 4
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
-
- Rehabilitation Clinic/Center
- Saint Paul, MN
- NPI 1134157092
-
- Emergency Medicine Physician
- Saint Paul, MN
- NPI 1154359917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1316491970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 RIVER LN",
"city": "ANOKA",
"state": "MN",
"postal_code": "553032807",
"telephone_number": "763-567-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 PHALEN BLVD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551305302",
"telephone_number": "651-254-3200"
}
],
"practiceLocations": [
{
"address_1": "1710 Suburban Ave",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551066636",
"country_code": "US",
"telephone_number": "651-254-3200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "640 Jackson St",
"address_2": "Rehabilitation Institute",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551012502",
"country_code": "US",
"telephone_number": "651-254-2097",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEZAR",
"first_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "105115",
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.