MRS. MAXINE WALSH – Occupational Therapist, NPI 1194049577

MRS. MAXINE WALSH is a healthcare provider. based in Bridgeport, Connecticut. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 001136 (CT). The NPI Number for MRS. MAXINE WALSH is 1194049577

Main info

Female
Sole Proprietor
34 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MAXINE WALSH
NPI
1194049577
Phone
(203) 365-6443
Address
4200 PARK AVE
Enumeration Date
15 March 2010
Last Update Date
26 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2033656400
Graduation Year
1992 (34 years ago)
PAC ID
1456634484
Group Practice PAC ID
6901706332
Professional Enrollment ID
I20170216001629
Address ID
CT066041049BR4200XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:16State licenses:1Digital endpointsOther names

249 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in CT

Provider Addresses for MRS. MAXINE WALSH

  • 4200 PARK AVE

    BRIDGEPORT, CT 066041049

    Phone: (203) 365-6443

    Fax: (203) 396-1046

    Type: Mailing

  • 175, Jefferson Street, Newfield, Bridgeport, Fairfield County, Connecticut, 06607, United States

    FAIRFIELD, CT 068251078

    Phone: (203) 365-6443

    Fax: (203) 396-1046

    Type: Mailing

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: 2017-02-16

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
I20170216001629IOccupational Therapist In Private PracticeCTTBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes45812$0
View full utilization report →

Insurance plans in this area (ZIP 06604)

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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: 6901706332View full group profile
NameSpecialtyState
Qualified Speech Language PathologistCT
Physical Therapist In Private PracticeCT
Occupational Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Occupational Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
-CT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeMA

Reviews

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Frequently asked questions

What number should I use to identify MRS. MAXINE WALSH for billing?
Administrative and clinical systems typically use NPI 1194049577 for MRS. MAXINE WALSH.
Does the public listing show MRS. MAXINE WALSH as active?
MRS. MAXINE WALSH's NPI record reflects an active status in NPPES.
What type of care does MRS. MAXINE WALSH provide?
MRS. MAXINE WALSH's profile centers on Occupational Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to MRS. MAXINE WALSH?
MRS. MAXINE WALSH shows a connection to Bridgeport, Connecticut in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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