Individual provider Active NPI

Tricia Arline Kloeckl, OTR/L

  • Occupational Therapist
  • Saint Paul, MN
National Provider Identifier
1487753018
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
101430 Issued in MN
Practice address
435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone
(651) 254-3200
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 534 SC
Occupational Therapist 225X00000X 101430 MN Primary

Addresses

Primary practice location

435 Phalen Blvd
Saint Paul, MN 55130-5302

Mailing address

6465 Wayzata Blvd
Ste 315
St Louis Park, MN 55426-1728

Other practice location 1

7550 34th Ave S
Minneapolis, MN 55450-1124
Phone (952) 993-9830

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061212000567 MN Practitioner - Occupational Therapist in Private Practice 3678572047 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

3800 American Blvd W
Suite 200
Bloomington, MN 55431-4420
Phone (952) 831-8742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital Current Accepting new patients
Regions Hospital CurrentSince Apr 1, 2017 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Dec 10, 2016 Accepting new patients
Regions Hospital CurrentSince Apr 1, 2017 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Clinic CurrentSince Aug 1, 2006 Accepting new patients

Locations

3800 American Blvd W
Ste 200
Bloomington, MN 55431
Phone (952) 806-5510

7550 34th Ave S
Minneapolis, MN 55450
Phone (612) 727-1167

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

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

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

Organizations & group practices 6

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487753018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "STE 315",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "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": "7550 34th Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554501124",
            "country_code": "US",
            "telephone_number": "952-993-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOECKL",
        "first_name": "TRICIA",
        "middle_name": "ARLINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "534",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "101430",
            "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 Mar 17, 2018; 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.