ANDREA MICHELLE STACY (OTR/L) – Occupational Therapist, NPI 1093699829

ANDREA MICHELLE STACY (OTR/L) is a healthcare provider. based in Chicago, Illinois. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. 056003713 (IL). The NPI Number for ANDREA MICHELLE STACY (OTR/L) is 1093699829

Main info

Female
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA MICHELLE STACY (OTR/L)
NPI
1093699829
Phone
Not provided
Address
311 E CULLERTON ST UNIT 3
Enumeration Date
4 August 2025
Last Update Date
4 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6308002444
Graduation Year
1994 (32 years ago)
PAC ID
7810497013
Group Practice PAC ID
3870785132
Professional Enrollment ID
I20250822000750
Address ID
IL606575083CH2835XAVEX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

973 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in IL

Provider Addresses for ANDREA MICHELLE STACY (OTR/L)

  • 311 E CULLERTON ST UNIT 3

    CHICAGO, IL 606164323

    Phone:

    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: 2025-08-22

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
I20250822000750IOccupational Therapist In Private PracticeILTBD

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 60616)

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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: 3870785132View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Occupational Therapist In Private PracticeIL
Qualified Speech Language PathologistIL
-IL
Physical Therapist In Private PracticeIL
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIL
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Is there an official ID for ANDREA MICHELLE STACY (OTR/L) in U.S. healthcare records?
The official identifier for ANDREA MICHELLE STACY (OTR/L) is NPI 1093699829.
Is ANDREA MICHELLE STACY (OTR/L) shown as active in public data?
Registry records indicate ANDREA MICHELLE STACY (OTR/L) maintains an active NPI.
What expertise is attributed to ANDREA MICHELLE STACY (OTR/L)?
ANDREA MICHELLE STACY (OTR/L)'s specialty line reads Occupational Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ANDREA MICHELLE STACY (OTR/L)?
Travel planning: use Chicago, Illinois as the reference point for ANDREA MICHELLE STACY (OTR/L), then confirm.
When was this NPI issued?
Enumeration for ANDREA MICHELLE STACY (OTR/L) is noted as August 4, 2025 where the registry provides it.

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