MALLORY R MASSEY (OTR/L) – Physical Rehabilitation Occupational Therapist, NPI 1548097439

MALLORY R MASSEY (OTR/L) is a healthcare provider. based in Jacksonville, Florida. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. 25609 (FL). The NPI Number for MALLORY R MASSEY (OTR/L) is 1548097439

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MALLORY R MASSEY (OTR/L)
NPI
1548097439
Phone
(904) 371-4649
Address
4745 SUTTON PARK CT STE 403
Enumeration Date
16 September 2024
Last Update Date
16 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9043714649
Graduation Year
2024 (2 years ago)
PAC ID
0648792069
Group Practice PAC ID
8527197441
Professional Enrollment ID
I20250314001669
Address ID
FL322240255JA4745XCTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,139 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for MALLORY R MASSEY (OTR/L)

  • 4745 SUTTON PARK CT STE 403

    JACKSONVILLE, FL 322240255

    Phone: (904) 371-4649

    Fax: (888) 393-1099

    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: 2025-03-14

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
I20250314001669IOccupational Therapist In Private PracticeFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32224)

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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: 8527197441View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
-FL
Occupational Therapist In Private PracticeFL
Occupational Therapist In Private PracticeIL
-FL
-FL
Occupational Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Can I cross-check MALLORY R MASSEY (OTR/L) using NPI 1548097439?
NPI 1548097439 belongs to MALLORY R MASSEY (OTR/L); compare other details if you need extra assurance.
Is MALLORY R MASSEY (OTR/L) shown as active in public data?
Registry records indicate MALLORY R MASSEY (OTR/L) maintains an active NPI.
What area of care is associated with MALLORY R MASSEY (OTR/L)?
MALLORY R MASSEY (OTR/L)'s record emphasizes Physical Rehabilitation Occupational Therapist. Clinical services aligned with this taxonomy classification.
Is MALLORY R MASSEY (OTR/L) located near Jacksonville?
MALLORY R MASSEY (OTR/L) currently maps to Jacksonville, Florida in this extract.
When was this NPI issued?
Enumeration for MALLORY R MASSEY (OTR/L) is noted as September 16, 2024 where the registry provides it.

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