MATT ALAN ANDERSON (OTR) – Hand Occupational Therapist, NPI 1457375917

MATT ALAN ANDERSON (OTR) is a healthcare provider. based in Golden valley, Minnesota. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR. They hold a License No. 102376 (MN). The NPI Number for MATT ALAN ANDERSON (OTR) is 1457375917

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
MATT ALAN ANDERSON (OTR)
NPI
1457375917
Phone
(952) 512-5600
Address
4200 DAHLBERG DR
Enumeration Date
27 July 2006
Last Update Date
14 August 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9524567600
Graduation Year
1998 (28 years ago)
PAC ID
9537358726
Group Practice PAC ID
1052225042
Professional Enrollment ID
I20110104000251
Address ID
MN551211002EA2700XCIRX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

603 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MN

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Provider Addresses for MATT ALAN ANDERSON (OTR)

  • Koch Industries, Inc. | Lehigh Consumer Group, LLC, 4200, Dahlberg Drive, Glenwood Junction, Golden Valley, Hennepin County, Minnesota, 55422, United States

    SUITE 300

    GOLDEN VALLEY, MN 554224840

    Phone: (952) 512-5600

    Fax: (952) 512-5651

    Type: Mailing

  • 1000, 140th Street West, Burnsville, Dakota County, Minnesota, 55337, United States

    SUITE 201

    BURNSVILLE, MN 55337

    Phone: (952) 808-3000

    Fax: (952) 808-3001

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110104000251IOccupational Therapist In Private PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97165Evaluation for occupational therapy, typically 30 minutes2322$0
View full utilization report →

Insurance plans in this area (ZIP 55422)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052225042View full group profile
NameSpecialtyState
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
-MN
Physical Therapist In Private PracticeMN
-MN
Orthopedic SurgeryMN
-MN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

How is MATT ALAN ANDERSON (OTR) identified in CMS data?
CMS-hosted NPPES data lists MATT ALAN ANDERSON (OTR) with NPI 1457375917.
Can I rely on MATT ALAN ANDERSON (OTR) being an active provider?
As of the registry snapshot, MATT ALAN ANDERSON (OTR) is marked active.
What is MATT ALAN ANDERSON (OTR)'s specialty?
The listing groups MATT ALAN ANDERSON (OTR) with Hand Occupational Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for MATT ALAN ANDERSON (OTR)?
MATT ALAN ANDERSON (OTR)'s geographic hint is Golden Valley, Minnesota in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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MAUREEN RIELLY MURRAY (O.T.C.)

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MRS. MICHELE LEIGH JACOBSON (OTR/L)

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