Individual provider Active NPI

Mary Rachael Gabrelcik, OTR/L

  • Pediatric Occupational Therapist
  • Andover, MN
National Provider Identifier
1831797984
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
106336 Issued in MN
Practice address
1891 Station Pkwy NW
Andover, MN 55304-3341
Phone
(763) 755-4275
NPI assigned
Oct 12, 2020
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 106336 MN Primary

Addresses

Primary practice location

1891 Station Pkwy NW
Andover, MN 55304-3341

Mailing address

1891 Station Pkwy NW
Andover, MN 55304-3341
Phone (763) 755-4275

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230001203 MN Practitioner - Occupational Therapist in Private Practice 7214340744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8425 Seasons Pkwy
Suite 105
Woodbury, MN 55125-4393
Phone (952) 993-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Dec 2, 2025 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Dec 2, 2025 Accepting new patients
Park Nicollet Clinic Current Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3525 Monterey Dr
St Louis Park, MN 55416
Phone (952) 993-1990

8425 Seasons Pkwy
Ste 105
Woodbury, MN 55125
Phone (952) 993-7672

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1831797984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043341",
            "telephone_number": "763-755-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043341",
            "telephone_number": "763-755-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRELCIK",
        "first_name": "MARY",
        "middle_name": "RACHAEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "106336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.