Jessie Bilitz Polzin, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103758 Issued in MN

Practice address

825 1St Ave NW
New Brighton, MN 55112-6846

Phone

(651) 633-7875

NPI assigned

Jul 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

University of Minnesota Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roots and Wings Therapeutic Services LLCGroup PAC ID 4284027806, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Roots and Wings Therapeutic Services LLC

  • Occupational Therapist
  • Rogers, MN
  • NPI 1902564420
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1407086630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15216 FANNING DR N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550386307",
            "telephone_number": "651-633-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 1ST AVE NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126846",
            "telephone_number": "651-633-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZIN",
        "first_name": "JESSIE",
        "middle_name": "BILITZ",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Care LLC
• Phoenix Health LLC
• Joualery Moua Piajyang
• Teresa Marie Pickett, PTA
• Brian Lewis Pierce, D.D.S.
• Preferred Choice Pharmacy
• Joseph Pribyl, L.M.F.T.
• Prime Choice Home Care, LLC
• Prosper Health Care LLC
• Keyanna Przybilla-Tucker

• Occupational Therapist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.