Individual provider Active NPI

Madelyn Hudlow, OTD, OTR/L

  • Occupational Therapist
  • Minneapolis, MN
National Provider Identifier
1699666370
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107832 Issued in MN
Practice address
1200 Marquette Ave
Minneapolis, MN 55403-2419
Phone
(612) 503-1990
NPI assigned
Jul 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 107832 MN Primary

Addresses

Primary practice location

1200 Marquette Ave
Minneapolis, MN 55403-2419

Mailing address

5001 Cherry LN
Rockford, MN 55373-2101
Phone (763) 607-0122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107002697 MN Practitioner - Occupational Therapist in Private Practice 3072003995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3395 Plymouth Rd
Minnetonka, MN 55305-3633

5001 Cherry LN
Rockford, MN 55373-2101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107832MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. David'S Center CurrentSince Aug 16, 2025 Accepting new patients
St. David'S Center Occupational Therapist CurrentSince Aug 16, 2025 Accepting new patients

Locations

1200 Marquette Ave
Minneapolis, MN 55403
Phone (612) 540-2911

3395 Plymouth Rd
Minnetonka, MN 55305
Phone (952) 939-0396

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": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1699666370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 CHERRY LN",
            "city": "ROCKFORD",
            "state": "MN",
            "postal_code": "553732101",
            "telephone_number": "763-607-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MARQUETTE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032419",
            "telephone_number": "612-503-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDLOW",
        "first_name": "MADELYN",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.