Bianca Bonniwell, OTR/L
NPI 1639597685ActiveIndividual· Occupational Therapist· Buffalo, MN
Occupational Therapist (OTR/L) with St. Croix Regional Medical Center, practicing in Buffalo, Minnesota. Enrolled in Medicare as practitioner - occupational therapist in private practice and practitioner - occupational therapist in private practice.
Overview
| NPI | 1639597685 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OTR/L |
| Sole proprietor | No |
| NPI issued | Apr 6, 2014 |
| Last updated in NPPES | Dec 19, 2019 |
| Certified by provider | Dec 19, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | 104457 | MN |
| Occupational Therapist, Pediatrics | 225XP0200X | — | MN |
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); Practitioner - Occupational Therapist in Private Practice (WI) |
|---|
Education and affiliations
| Graduation year | 2012 |
|---|---|
| Medicare specialty | Occupational Therapist In Private Practice |
Medical group
- St. Croix Regional Medical CenterLindstrom, MN · 131 clinicians
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