Individual provider Active NPI

Monicah Nyakoe, OT

  • Occupational Therapist
  • Burnsville, MN
National Provider Identifier
1346061371
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
14451 Grand Ave
Burnsville, MN 55306-5708
Phone
(701) 441-9496
NPI assigned
Oct 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 Primary

Addresses

Primary practice location

14451 Grand Ave
Burnsville, MN 55306-5708

Mailing address

4217 39 1/2 Ave S
Fargo, ND 58104-6972
Phone (701) 441-9496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118003145 MN Practitioner - Occupational Therapist in Private Practice 1759816440 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Oct 27, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince Nov 11, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince Nov 11, 2024 Accepting new patients
Park Nicollet Clinic PastSince Oct 27, 2024 Accepting new patients

Locations

14451 Grand Ave S
Burnsville, MN 55306
Phone (701) 441-9496

15301 Grove Cir N
Maple Grove, MN 55369
Phone (952) 412-3463

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

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

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.

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1346061371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 39 1/2 AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046972",
            "telephone_number": "701-441-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14451 GRAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065708",
            "telephone_number": "701-441-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAKOE",
        "first_name": "MONICAH",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.

Verify at the official NPI Registry.