Mellissa Mary Moen, OTR
NPI 1053652248ActiveIndividual· Occupational Therapist· Saint Paul, MN
Occupational Therapist (OTR) with Active Therapy Mn, practicing in Saint Paul, Minnesota. Enrolled in Medicare as practitioner - occupational therapist in private practice.
Overview
| NPI | 1053652248 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OTR |
| Sole proprietor | No |
| NPI issued | Mar 13, 2013 |
| Last updated in NPPES | Apr 27, 2026 |
| Certified by provider | Apr 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Occupational Therapist in Private Practice (MN) |
|---|
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Occupational Therapist In Private Practice |
Medical group
- Active Therapy MnEden Prairie, MN · 21 clinicians
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