Individual provider Active NPI

Brianna Jastram, MOTR/L

  • Occupational Therapist
  • Fargo, ND
National Provider Identifier
1821444100
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1480 Issued in ND
Practice address
3244 51St St S
Fargo, ND 58104-7179
Phone
(701) 356-0062
Fax
(701) 356-5412
NPI assigned
May 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 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 1480 ND Primary

Addresses

Primary practice location

3244 51St St S
Fargo, ND 58104-7179

Mailing address

3244 51St St S
Fargo, ND 58104-7179
Phone (701) 356-0062

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629002314 ND Practitioner - Occupational Therapist in Private Practice 8224320817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beyond Boundaries Occupational Therapy IncGroup PAC ID 9133298599, 15 clinicians

Practice addresses (Care Compare)

3244 51St St S
Fargo, ND 58104-7179
Phone (701) 356-0062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1480NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Boundaries Occupational Therapy, Inc. Occupational Therapist CurrentSince Sep 10, 2019 Accepting new patients
Beyond Boundaries Speech Language Therapy, Inc. CurrentSince Sep 10, 2019 Accepting new patients

Locations

3244 51st St S
Fargo, ND 58104
Phone (701) 356-0062

3001 11th St S
Fargo, ND 58103
Phone (701) 356-0062

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": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1821444100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179",
            "telephone_number": "701-356-0062",
            "fax_number": "701-356-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179",
            "telephone_number": "701-356-0062",
            "fax_number": "701-356-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASTRAM",
        "first_name": "BRIANNA",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.