ED A DETELS (OT) – Occupational Therapist, NPI 1427033604
Occupational Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,224 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in CA
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Provider Addresses for ED A DETELS (OT)
200, Newport Center Drive, Fashion Island, Newport Center, Newport Beach, Orange County, California, 92660, United States
#213
NEWPORT BEACH, CA 926607501
Phone: (949) 644-1322
Fax: (949) 644-0316
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.
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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: 2005-04-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050407001358 | I | Occupational Therapist In Private Practice | CA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97140 | Therapy procedure using manual technique, each 15 minutes | 1,638 | 197 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1,525 | 191 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 1,041 | 142 | $0 |
| 97018 | Application of hot wax bath | 1,005 | 150 | $0 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 867 | 96 | $0 |
Insurance plans in this area (ZIP 92660)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OCCUPATIONAL THERAPY | CA | 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 646 | 91 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | CA | |
| - | CA | |
| Occupational Therapist In Private Practice | CA | |
| - | CA | |
| Physical Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | CA |
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