Individual provider Active NPI

Melissa Lee Roeske, MOT, OTRL

  • Pediatric Occupational Therapist
  • Burnsville, MN
National Provider Identifier
1356662225
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
100576 Issued in MN
Practice address
100 Cobblestone LN
Burnsville, MN 55337-4578
Phone
(952) 898-5700
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 100576 MN Primary

Addresses

Primary practice location

100 Cobblestone LN
Burnsville, MN 55337-4578

Mailing address

1644 Sherwood Way
Eagan, MN 55122-2711
Phone (651) 683-9346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100576MNMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Courage Residence Past Accepting new patients

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1356662225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 SHERWOOD WAY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222711",
            "telephone_number": "651-683-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COBBLESTONE LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374578",
            "telephone_number": "952-898-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESKE",
        "first_name": "MELISSA",
        "middle_name": "LEE",
        "credential": "MOT, OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "100576",
            "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 Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.