Jessica M Baumgartner, O.T.R/L
Individual provider Active NPI Occupational Therapist · Fargo, ND
NPI 1992851695 · NPPES record last updated Oct 29, 2019
Key facts
- NPI
- 1992851695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 617 (ND)
- Practice address
- 4450 31St Ave S Ste 104
Fargo, ND 58104-4557 - Phone
- (701) 451-9417
- Fax
- (701) 298-0066
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Rehabilitation Center Inc
Practice addresses (Care Compare)
1200 Harwood Dr S
Fargo, ND 58104-6298
Phone (701) 451-9417
4450 31St Ave S
Suite 104
Fargo, ND 58104-4557
Phone (701) 451-9417
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.38 of 100
- Quality
- 89.93
- Improvement activities
- 40
- Cost
- 81.37
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081119000224 | ND | Practitioner - Occupational Therapist in Private Practice | 0648330704 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 617 | ND | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Rehabilitation Center Inc | Occupational Therapist | Current |
Accepting new patients |
| Professional Rehabilitation Center Inc | Occupational Therapist | Current |
Accepting new patients |
Locations
4450 31st Ave S
Ste 104
Fargo, ND 58104
Phone (701) 451-9417
1711 Gold Dr S
Ste 120
Fargo, ND 58103
Phone (701) 298-0065
1200 Harwood Dr S
Fargo, ND 58104
Phone (701) 451-4811
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 617 | ND | Yes |
Addresses
Primary practice location
4450 31St Ave S Ste 104
Fargo, ND 58104-4557
Mailing address
4450 31St Ave S Ste 104
Fargo, ND 58104-4557
Phone (701) 451-9417
Other providers in Fargo, ND
- Ann Marie Baumeister
- Jennifer Baumeister
- David Paul Baumgardner
- Rachel Baumgart
- April Baumgartner
- Mary Susan Baumgartner
- Peyton Boom Baumgartner
- Tammy Jo Baumgartner
- Tom L Baumgartner Jr.
- Aaron Gregory Baune
All providers in Fargo, ND · Occupational Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.