Active NPI
Gabriel Douglas Orem, OTR/L
- Occupational Therapist
- Minnetonka, MN
National Provider Identifier
1649739103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 105883
- Practice address
- 10653 Waysata Blvd.
Suite 200
Minnetonka, MN 55305 - Phone
- (952) 224-1919
- NPI assigned
- Mar 14, 2019
- Sex
- Male
- 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 | 105883 | MN | Primary |
Addresses
Primary practice location
10653 Waysata Blvd.
Suite 200
Minnetonka, MN 55305
Mailing address
1401 Circle Terrace Blvd NE Apt 2
Columbia Heights, MN 55421-2645
Phone (815) 222-5831
Other practice location 1
3801 Hart Blvd
Columbia Heights, MN 55421-4106
Phone (763) 210-6697 ext. 2705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
4350 Morsay Dr
Rockford, IL 61107-4877
Phone (815) 398-4500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine and Body Renewal PLLC | Occupational Therapist | Current | Accepting new patients |
Locations
4350 Morsay Dr
Rockford, IL 61107
Phone (815) 395-1100
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": "1552521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552521600000",
"number": "1649739103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 CIRCLE TERRACE BLVD NE APT 2",
"city": "COLUMBIA HEIGHTS",
"state": "MN",
"postal_code": "554212645",
"telephone_number": "815-222-5831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10653 WAYSATA BLVD.",
"address_2": "SUITE 200",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "55305",
"telephone_number": "952-224-1919"
}
],
"practiceLocations": [
{
"address_1": "3801 Hart Blvd",
"address_purpose": "LOCATION",
"city": "Columbia Heights",
"state": "MN",
"postal_code": "554214106",
"country_code": "US",
"telephone_number": "763-210-6697 x2705",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OREM",
"first_name": "GABRIEL",
"middle_name": "DOUGLAS",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-14",
"last_updated": "2019-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "105883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.