Amanda R Blom, OTR/L, CLT-LANA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105013 Issued in MN

Practice address

200 1St St SW
Rochester, MN 55905-8706

Phone

(507) 284-2511

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ablom1721494@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment Care Compare group NPD
• Mayo Clinic

  • Clinical Medical Laboratory
  • Rochester, MN
  • NPI 1083249577
  NPD
• Mayo Clinic

  • Medical Specialty Clinic/Center
  • Rochester, MN
  • NPI 1427235068
  NPD

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1801247895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559058706",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4527 Shoreline Dr",
            "address_purpose": "LOCATION",
            "city": "Spring Park",
            "state": "MN",
            "postal_code": "553848706",
            "country_code": "US",
            "telephone_number": "952-471-3946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOM",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "OTR/L, CLT-LANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5904 - 26",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ablom1721494@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559058706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Louise J Blissenbach, LICSW
• Kristen R. Blixt, RDN LD
• Kelsey Alexis Block, PA-C
• Matthew S Block, MD, PHD
• Riddick Richard Blocker IV, MD
• Jennifer Blomberg, MSW, LGSW, LADC
• Michele Gaertner Blomquist, M.D.
• Patricia Pringle Bloom, MD
• Bloomcare Therapy
• Brendon Scott Bloomfield

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.