Andrea Ann Janike, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106053 Issued in MN

Practice address

15600 36TH Ave N Ste 120
Plymouth, MN 55446-3687

Phone

(763) 595-0812

Fax

(763) 595-0824

NPI assigned

Jan 27, 2021

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

Other names 1

• Andrea Ann Paumen Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Minnetonka Pediatric Therapy Center, LLC

  • Speech-Language Pathologist
  • Plymouth, MN
  • NPI 1891998035

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1679164198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 36TH AVE N STE 120",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463687",
            "telephone_number": "763-595-0812",
            "fax_number": "763-595-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 36TH AVE N STE 120",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463687",
            "telephone_number": "763-595-0812",
            "fax_number": "763-595-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANIKE",
        "first_name": "ANDREA",
        "middle_name": "ANN",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "PAUMEN",
            "middle_name": "ANN",
            "credential": "MOTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Jacobson
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• Jordanna Joy James, LPCC
• Michael R Janisch, DNP
• Tamara Janousek, OT
• Martin J Janowak, LMT, CST, BCTMB
• Jennifer Jasperson, LMFT
• Emily Ann Jaworski, MSW, LICSW

• Occupational Therapist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.