NICOLE TETRAULT OTR
NPI 1568873644
Occupational Therapist in Shoreview, MN
About Nicole Tetrault Otr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE TETRAULT OTR (NPI 1568873644) is an individual occupational therapist in Shoreview, Minnesota, licensed in Minnesota (104647) and active in the NPI registry since May 2014. She maintains a secondary practice location in Hugo.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Nicole Tetrault Otr is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Nicole Tetrault reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Shoreview, MN 55126
- Reassigned Medicare billing, Minnesota enrollment
- 19 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 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SHOREVIEW, MN 55126
SHOREVIEW, MN 55126
SHOREVIEW, MN 55126
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 Nicole Tetrault's NPI number?
The NPI number for Nicole Tetrault is 1568873644. It was assigned to this individual provider in the NPPES registry on May 12, 2014.
Where is Nicole Tetrault located?
Nicole Tetrault practices at 490 Highway 96 W Ste 300, Shoreview, MN 55126. The listed phone number is (651) 451-3016.
What is Nicole Tetrault's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Nicole Tetrault enrolled in Medicare?
Yes. Nicole Tetrault is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Nicole Tetrault's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Tetrault reassigns Medicare benefits to Kids Abilities, Inc (Shoreview, MN). The 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 Nicole Tetrault'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 Nicole Tetrault was last updated on November 29, 2022. 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.