Individual provider Active NPI

Anders Wallock, MOT, OTR/L

  • Occupational Therapist
  • Saint Paul, MN
National Provider Identifier
1982294542
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
106414 Issued in MN
Practice address
2270 Ford Pkwy Ste 200
Saint Paul, MN 55116-3412
Phone
(651) 696-5010
NPI assigned
Jan 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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 106414 MN Primary

Addresses

Primary practice location

2270 Ford Pkwy Ste 200
Saint Paul, MN 55116-3412

Mailing address

2270 Ford Pkwy Ste 200
Saint Paul, MN 55116-3412
Phone (651) 696-5010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212001416 MN Practitioner - Occupational Therapist in Private Practice 2062881113 Reassigns benefits to 3 organizations

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
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

800 Freeport Ave NW
Suite 200
Elk River, MN 55330-2725
Phone (612) 672-5787

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106414MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Dec 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Outpatient Services, LLC Occupational Therapist CurrentSince Dec 1, 2022 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

800 Freeport Ave NW
Ste 200
Elk River, MN 55330
Phone (612) 672-5775

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

10961 Club West Pkwy
Ste 200
Minneapolis, MN 55449
Phone (763) 528-2922

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 6

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": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1982294542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 FORD PKWY STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163412",
            "telephone_number": "651-696-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 FORD PKWY STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163412",
            "telephone_number": "651-696-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLOCK",
        "first_name": "ANDERS",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-19",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.