Individual provider Active NPI

Ryan H Goeke, OT

  • Occupational Therapist
  • Burnsville, MN
National Provider Identifier
1780710061
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
103428 Issued in MN
Practice address
501 E Nicollet Blvd Ste 100
Burnsville, MN 55337-6772
Phone
(952) 435-8516
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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 103428 MN Primary

Addresses

Primary practice location

501 E Nicollet Blvd Ste 100
Burnsville, MN 55337-6772

Mailing address

501 E Nicollet Blvd Ste 100
Burnsville, MN 55337-6772
Phone (952) 435-8516

Other practice location 1

3400 W 66th St Ste 150
Edina, MN 55435-2109
Phone (952) 920-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070404000137 MN Practitioner - Occupational Therapist in Private Practice 1850495631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minneapolis Clinic of Neurology LTDGroup PAC ID 5496668659, 75 clinicians

Practice addresses (Care Compare)

501 E Nicollet Boulevard
Suite 100 and Suite LL50
Burnsville, MN 55337-6749
Phone (952) 435-8516

Merit-based Incentive Payment System (MIPS)

Final score
92.39 of 100Reported as group
Quality
84.12
Promoting interoperability
100
Improvement activities
40
Cost
83.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103428MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Minneapolis Clinic of Neurology, LTD CurrentSince Apr 1, 2020 Accepting new patients
Laboratory Corportation of America Holdings PastSince Apr 1, 2020 Accepting new patients

Locations

501 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

3400 W 66th St
Ste 150
Minneapolis, MN 55435
Phone (952) 920-7200

4225 Golden Valley Rd
Minneapolis, MN 55422
Phone (612) 588-0661

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1780710061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E NICOLLET BLVD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376772",
            "telephone_number": "952-435-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E NICOLLET BLVD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376772",
            "telephone_number": "952-435-8516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 W 66th St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352109",
            "country_code": "US",
            "telephone_number": "952-920-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOEKE",
        "first_name": "RYAN",
        "middle_name": "H",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.