Individual provider Active NPI

Kimberly Anne Kaliszewski, OTR/L

  • Occupational Therapist
  • Duluth, MN
National Provider Identifier
1790988525
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
TEMPORARY # 103479 Issued in MN
Practice address
4002 London Rd
Duluth, MN 55804-2243
Phone
(218) 625-8295
NPI assigned
Jun 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 TEMPORARY # 103479 MN Primary

Addresses

Primary practice location

4002 London Rd
Duluth, MN 55804-2243

Mailing address

2105 E 1St St
Duluth, MN 55812-1804

Other practice location 1

407 E 3rd St
Duluth, MN 55805-1950
Phone (218) 786-4000

Other names 1

  • Kimberly Anne Ambright Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250822002751 MN Practitioner - Occupational Therapist in Private Practice 2961902036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TEMPORARY # 103479MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Aug 8, 2025 Accepting new patients
The Duluth Clinic LTD CurrentSince Aug 8, 2025 Accepting new patients

Locations

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

4002 London Rd
Duluth, MN 55804
Phone (218) 525-1951

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1790988525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042243",
            "telephone_number": "218-625-8295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051950",
            "country_code": "US",
            "telephone_number": "218-786-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALISZEWSKI",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "TEMPORARY # 103479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "AMBRIGHT",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.