Individual provider Active NPI

Alycia Heisler, MOT, OTR/L

  • Occupational Therapist
  • Ogema, MN
National Provider Identifier
1992357362
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
105772 Issued in MN
Practice address
40520 County Highway 34
Ogema, MN 56569-9612
Phone
(218) 983-4300
Fax
(218) 983-6307
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1725 ND
Occupational Therapist 225X00000X 105772 MN Primary

Addresses

Primary practice location

40520 County Highway 34
Ogema, MN 56569-9612

Mailing address

40520 County Highway 34
Ogema, MN 56569-9612
Phone (218) 983-4300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607002653 TX Practitioner - Occupational Therapist in Private Practice 4587992755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Earth Indian Health Center 36 clinicians

Practice addresses (Care Compare)

40520 County Hwy 34
Ogema, MN 56569-9612
Phone (218) 983-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105772MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
White Earth Indian Health Center CurrentSince Apr 1, 2022 Accepting new patients
Naytahwaush Health Center CurrentSince Apr 1, 2022 Accepting new patients
Pediatric Therapy Partners, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Pine Point Health Station Current Accepting new patients
Anne Carlsen Center for Children PastSince Dec 16, 2020 Accepting new patients

Locations

40520 County Highway 34
#C
Ogema, MN 56569
Phone (218) 983-4300

40520 County Highway 34
Ogema, MN 56569
Phone (218) 983-4300

3401 45th St S
#A
Fargo, ND 58104
Phone (701) 356-4384

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

Organizations & group practices 5

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1992357362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISLER",
        "first_name": "ALYCIA",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1725",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogema, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.