Individual provider Active NPI

Hannah Rose Stegora

  • Pediatric Occupational Therapist
  • White Bear Lake, MN
National Provider Identifier
1437656113
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
2555 County Road E E
White Bear Lake, MN 55110-4906
Phone
(651) 773-5988
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Pediatric Occupational Therapist 225XP0200X Primary

Addresses

Primary practice location

2555 County Road E E
White Bear Lake, MN 55110-4906

Mailing address

2555 County Road E E
White Bear Lake, MN 55110-4906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006003287 MN Practitioner - Occupational Therapist in Private Practice 6204234180 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Speech Therapy, LLC CurrentSince Aug 2, 2021 Accepting new patients
Advance Occupational Therapy, LLC CurrentSince Aug 2, 2021 Accepting new patients

Locations

6776 Lake Dr
Ste 220
Lino Lakes, MN 55014
Phone (651) 784-7007

2555 County Road E E
White Bear Lk, MN 55110
Phone (651) 241-9200

Organizations & group practices 2

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1437656113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COUNTY ROAD E E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COUNTY ROAD E E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104906",
            "telephone_number": "651-773-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGORA",
        "first_name": "HANNAH",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.

Verify at the official NPI Registry.