Active NPI
Angela Tilsen, COTA
- Occupational Therapist
- Saint Louis Park, MN
National Provider Identifier
1598110439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 202112
- Practice address
- 4415 W 36 1/2 St
Saint Louis Park, MN 55416-4854 - Phone
- (952) 927-9717
- NPI assigned
- Apr 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 202112 | MN | Primary |
Addresses
Primary practice location
4415 W 36 1/2 St
Saint Louis Park, MN 55416-4854
Mailing address
2218 Spruce PL
White Bear Lake, MN 55110-4734
Phone (651) 210-3507
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
| License | State | Type | Specialty |
|---|---|---|---|
| 202112 | MN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evercare Collaborative Solutions Inc | 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.
-
- Registered Nurse
- Minnetonka, MN
- NPI 1285686378
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461801600000",
"number": "1598110439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2218 SPRUCE PL",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551104734",
"telephone_number": "651-210-3507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4415 W 36 1/2 ST",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554164854",
"telephone_number": "952-927-9717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILSEN",
"first_name": "ANGELA",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-28",
"last_updated": "2016-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "202112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.