PAUL LINDSAY PETTYJOHN (OT) – Occupational Therapist, NPI 1952469686
Occupational Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,224 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in CA
Provider Addresses for PAUL LINDSAY PETTYJOHN (OT)
100 N Barranca St Ste 380
West Covina, CA 917911637
Phone: (626) 331-8355
Fax: (909) 890-4393
Type: Location
1845 BUSINESS CENTER DR STE 127
SAN BERNARDINO, CA 924083434
Phone: (909) 890-9030
Fax: (909) 890-4393
Type: Mailing
500 N CENTRAL AVE STE 850
GLENDALE, CA 912033354
Phone: (818) 549-9764
Fax: (818) 549-9767
Type: Location
6703, West Rio Grande Avenue, Tri-Cities, Benton County, Washington, 99336, United States
KENNEWICK, WA 993362623
Phone: (509) 460-5588
Fax: (509) 783-5438
Type: Mailing
6699, West Rio Grande Avenue, Tri-Cities, Benton County, Washington, 99336, United States
KENNEWICK, WA 993363301
Phone: (509) 460-5588
Fax: (509) 783-5438
Type: Location
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: 2016-04-05
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 |
|---|---|---|---|---|
| I20160405002485 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91791)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| Occupational Therapist In Private Practice | CA | |
| Occupational Therapist In Private Practice | CA | |
| Occupational Therapist In Private Practice | CA |
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