Leah Pederson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

104218 Issued in MN

Practice address

4791 County Road 10 Ste 102
Moose Lake, MN 55767-9221

Phone

(218) 485-2020

Fax

(218) 485-2044

NPI assigned

Aug 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapy Partners IncGroup PAC ID 4486552593, 135 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Therapy Partners, Inc.

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1407809494

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Therapy Partners Inc

  • Physical Therapist
  • Forest Lake, MN
  • NPI 1821179607

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1851648885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MINNEHAHA AVE W STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041033",
            "telephone_number": "651-748-4338",
            "fax_number": "651-748-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 COUNTY ROAD 10 STE 102",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679221",
            "telephone_number": "218-485-2020",
            "fax_number": "218-485-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "LEAH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Lakes Surgery Center LLC
• Northern Lakes Surgery Center LLC
• Northern Lakes Surgery Center LLC
• Dana Marie Osborne, M.A., LPCC, LICSW
• Keri Ann Ovsak, RN, MA, FNP-BC
• Susan E. Persons, MS, LP
• Leann Poirier, OTR/L
• Barbara J. Reed, M.D.
• Randy J. Rice, M.D.
• Sonja M. Roach, N.P.

• Occupational Therapist in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.