ALISSA DEARDORFF OTR/L
NPI 1528693785
Occupational Therapist - Pediatrics in Maple Grove, MN

Active since March 09, 2020
15301 GROVE CIR N, MAPLE GROVE, MN 55369(952) 993-5900 Get Directions Write a Review

NPPES record last updated: January 4, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 4, 2023, May 17, 2021, Mar 9, 2020 (3 updates tracked since 2020).

About Alissa Deardorff Otr/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALISSA DEARDORFF OTR/L (NPI 1528693785) is an individual pediatrics provider in Maple Grove, Minnesota and active in the NPI registry since March 2020. She maintains a secondary practice location in Andover.

NPPES Registry Identity

NPI1528693785
Entity TypeIndividualFemale
Primary Taxonomy225XP0200X
Provider Legal NameALISSA DEARDORFFCredential: OTR/L
Location Address15301 GROVE CIR NMaple Grove, MN 55369-4475
Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516
Sole ProprietorNo
Enumeration DateMarch 9, 2020
Last NPPES UpdateJanuary 4, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 4, 2023
✔ NPI 1528693785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225XP0200X
Definition
Occupational therapists provide services to infants, toddlers and children who have or who are at risk for developmental delays or disabilities. Occupational therapy is concerned with a child's ability to participate in daily life activities or occupations. Occupational therapists use their unique expertise to help children with social-emotional, physical, cognitive, communication, and adaptive behavioral challenges and to help children to be prepared for and perform important learning and school-related activities and to fulfill their rule as students. Through an understanding of the impact of disability, illness, and impairment on a child's development, plan, ability to learn new skills, and overall occupational performance, occupational therapists design interventions that promote healthy development, establish needed skills, and/or modify environments, all in support of participation in daily activities.
15301 GROVE CIR N, Maple Grove, MN 55369

Other Names 1

Former Name (1)Alissa Bartholomew

Secondary Practice Location 1

Location 11891 Station Pkwy NWAndover, MN 55304-3341 · Phone (763) 755-4275

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alissa Deardorff Otr/l is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Alissa Deardorff reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Family Medicine
7000 TARGET PKWY N
Brooklyn Park, MN 55445
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,527 clinicians in this Medicare group
Speech-Language Pathologist
1891 STATION PKWY NW
Andover, MN 55304
  • Reassigned Medicare billing, Minnesota enrollment
  • 112 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Physical Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Occupational Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Physical Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Occupational Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Physical Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Physical Therapist
15301 GROVE CIR N
MAPLE GROVE, MN 55369
Speech-Language Pathologist
15301 GROVE CIR N
MAPLE GROVE, MN 55369

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alissa Deardorff's NPI number?

The NPI number for Alissa Deardorff is 1528693785. It was assigned to this individual provider in the NPPES registry on March 9, 2020. The provider is also known as Alissa Bartholomew.

Where is Alissa Deardorff located?

Alissa Deardorff practices at 15301 Grove Cir N, Maple Grove, MN 55369. The listed phone number is (952) 993-5900.

What is Alissa Deardorff's specialty?

The primary specialty registered for this NPI is Occupational Therapist, specializing in Pediatrics, with taxonomy code 225XP0200X.

Is Alissa Deardorff enrolled in Medicare?

Yes. Alissa Deardorff is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Alissa Deardorff's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alissa Deardorff reassigns Medicare benefits to 2 organizations: Park Nicollet Clinic (Brooklyn Park, MN) and Family Speech & Therapy Services, LLC (Andover, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alissa Deardorff's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alissa Deardorff was last updated on January 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.