MARY R VANRAVENHORST (OTR/L) – Occupational Therapist, NPI 1164493144

MARY R VANRAVENHORST (OTR/L) is a healthcare provider. based in Mankato, Minnesota. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. 101743 (MN). The NPI Number for MARY R VANRAVENHORST (OTR/L) is 1164493144

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
MARY R VANRAVENHORST (OTR/L)
NPI
1164493144
Phone
(507) 388-5437
Address
150 ST. ANDREWS COURT
Enumeration Date
30 January 2006
Last Update Date
16 April 2015

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
5076251811
Graduation Year
1997 (29 years ago)
PAC ID
1557694510
Group Practice PAC ID
5597677955
Professional Enrollment ID
I20190605002619
Address ID
MN560028674MA1230XEXXX401
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

603 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MN

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Provider Addresses for MARY R VANRAVENHORST (OTR/L)

  • 150, Saint Andrews Court, Mankato, Blue Earth County, Minnesota, 56001, United States

    SUITE 310

    MANKATO, MN 56001

    Phone: (507) 388-5437

    Fax: (507) 388-2108

    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: 2019-06-05

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
I20190605002619IOccupational Therapist In Private PracticeMNTBD

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 56001)

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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: 5597677955View full group profile
NameSpecialtyState
Physician AssistantMN
Nurse PractitionerMN
-MN
Diagnostic RadiologyCO
Physician AssistantMN
P O D I A T R YMN
-MN
-MN
General SurgeryMN
Diagnostic Radiology, Internal MedicineMN

Reviews

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Frequently asked questions

What federal number belongs to MARY R VANRAVENHORST (OTR/L)?
The federal identifier for MARY R VANRAVENHORST (OTR/L) is NPI 1164493144.
Is MARY R VANRAVENHORST (OTR/L)'s NPI currently valid?
The extract we use shows MARY R VANRAVENHORST (OTR/L) as active.
Does MARY R VANRAVENHORST (OTR/L) list a primary specialty?
If you are matching referrals, note Occupational Therapist for MARY R VANRAVENHORST (OTR/L). Clinical services aligned with this taxonomy classification.
Does MARY R VANRAVENHORST (OTR/L) practice in Minnesota?
You will see Mankato, Minnesota on file for MARY R VANRAVENHORST (OTR/L) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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