MICHAEL J FENNO (PT) – Physical Therapist, NPI 1396720876

MICHAEL J FENNO (PT) is a healthcare provider. based in Oakland, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT25091 (CA). The NPI Number for MICHAEL J FENNO (PT) is 1396720876

Main info

Male
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL J FENNO (PT)
NPI
1396720876
Phone
(415) 652-6570
Address
400 29TH ST
Enumeration Date
7 December 2005
Last Update Date
1 October 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4158951705
Graduation Year
1998 (28 years ago)
PAC ID
7416007984
Group Practice PAC ID
6406022078
Professional Enrollment ID
I20090630000160
Address ID
CA949453118NO1427XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

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Provider Addresses for MICHAEL J FENNO (PT)

  • Summit Professional Building, 400, 29th Street, Northgate / Koreatown, Oakland, Alameda County, California, 94612, United States

    SUITE 502

    OAKLAND, CA 946093522

    Phone: (415) 652-6570

    Mailing address matches the actual address.

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: 2009-06-30

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
I20090630000160IPhysical Therapist In Private PracticeCATBD

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
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes1,481126$0
97530Therapy procedure using functional activities920111$0
97161Evaluation for physical therapy, typically 20 minutes9583$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes6420$0
View full utilization report →

Insurance plans in this area (ZIP 94609)

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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: 6406022078View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeRI
Physical Therapist In Private PracticeCA
-CA
-CA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
-MI
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

What NPI should I save for MICHAEL J FENNO (PT)?
Save NPI 1396720876 if you need a stable reference for MICHAEL J FENNO (PT).
Is MICHAEL J FENNO (PT) active in the national directory?
MICHAEL J FENNO (PT)'s public NPI profile is in an active state.
What does MICHAEL J FENNO (PT) treat or focus on?
Patients typically see MICHAEL J FENNO (PT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is MICHAEL J FENNO (PT)'s primary listing?
We display Oakland, California because that is what the record indicates for MICHAEL J FENNO (PT).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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