DIANN FISK (OTR) – Occupational Therapist, NPI 1427034032

DIANN FISK (OTR) is a healthcare provider. based in Grand rapids, Michigan. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR. They hold a License No. 5201006864 (MI). The NPI Number for DIANN FISK (OTR) is 1427034032

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
DIANN FISK (OTR)
NPI
1427034032
Phone
(616) 459-7101
Address
1111 LEFFINGWELL AVE NE
Enumeration Date
16 December 2005
Last Update Date
6 March 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6164597101
Graduation Year
2004 (22 years ago)
PAC ID
5991741415
Group Practice PAC ID
9537136403
Professional Enrollment ID
I20050706000312
Address ID
MI495256406GR1111XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

711 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MI

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Provider Addresses for DIANN FISK (OTR)

  • 1111, Leffingwell Avenue Northeast, Grand Rapids, Kent County, Michigan, 49525, United States

    SUITE 200

    GRAND RAPIDS, MI 495256406

    Phone: (616) 459-7101

    Fax: (616) 954-6483

    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: 2005-07-06

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
I20050706000312IOccupational Therapist In Private PracticeMITBD

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 minutes3418$0
View full utilization report →

Insurance plans in this area (ZIP 49525)

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Provider's Procedures

DIANN FISK (OTR) performs procedures in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OCCUPATIONAL THERAPYMI97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes1915

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: 9537136403View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeMI
Orthopedic SurgeryNH
Hand SurgeryMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
-MI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Medicine And RehabilitationMI
Physician AssistantMI

Reviews

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Frequently asked questions

What is the registry number for DIANN FISK (OTR)?
The registry entry for DIANN FISK (OTR) shows NPI 1427034032.
Is DIANN FISK (OTR)'s NPI status active today?
Active status means DIANN FISK (OTR)'s NPI record is not deactivated in the public file.
How should patients interpret DIANN FISK (OTR)'s specialty?
The extract shows Occupational Therapist for DIANN FISK (OTR). Clinical services aligned with this taxonomy classification.
Is DIANN FISK (OTR) tied to Grand Rapids, Michigan?
If you are local to Grand Rapids, Michigan, DIANN FISK (OTR) may be relevant to your search.
Why is information missing for DIANN FISK (OTR)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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