MELANIE KETCHMARK – Physical Therapist, NPI 1285365940

MELANIE KETCHMARK is a healthcare provider. based in Brookfield, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for MELANIE KETCHMARK is 1285365940

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MELANIE KETCHMARK
NPI
1285365940
Phone
(619) 777-3758
Address
3114 RAYMOND AVE
Enumeration Date
22 June 2022
Last Update Date
22 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7086914890
Graduation Year
2002 (24 years ago)
PAC ID
1355726084
Group Practice PAC ID
3476082850
Professional Enrollment ID
I20220916001735
Address ID
IL604488374MO9019XLNXX300

Contacts

Secure Messaging
DORForestPark@renewalrehab.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness85
Years active:3State licenses:0Other namesUpdated within 12 months

5,028 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

Provider Addresses for MELANIE KETCHMARK

  • 3114 RAYMOND AVE

    BROOKFIELD, IL 605131246

    Phone: (619) 777-3758

    Type: Mailing

  • 8200 ROOSEVELT RD

    FOREST PARK, IL 601302528

    Phone: (708) 850-4889

    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: 2022-09-16

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
I20220916001735IPhysical 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 60513)

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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: 3476082850View full group profile
NameSpecialtyState
Nurse PractitionerIL
Physical Therapist In Private PracticeIL
Physician AssistantIL
Physical Therapist In Private PracticeIL
Occupational Therapist In Private PracticeIL

Reviews

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Frequently asked questions

Is there an official ID for MELANIE KETCHMARK in U.S. healthcare records?
The official identifier for MELANIE KETCHMARK is NPI 1285365940.
Would MELANIE KETCHMARK appear as active to a payer?
You can treat MELANIE KETCHMARK as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MELANIE KETCHMARK?
MELANIE KETCHMARK's record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
Is MELANIE KETCHMARK associated with Brookfield?
Public fields place MELANIE KETCHMARK around Brookfield, Illinois. Always confirm the exact site before visiting.
Does MELANIE KETCHMARK accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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