PETER O'MALIA (LICSW) – Clinical Social Worker, NPI 1326893587

PETER O'MALIA (LICSW) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 22644 (MN). The NPI Number for PETER O'MALIA (LICSW) is 1326893587

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
PETER O'MALIA (LICSW)
NPI
1326893587
Phone
Not provided
Address
4421 14TH AVE S
Enumeration Date
22 April 2024
Last Update Date
22 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512667900
Graduation Year
2013 (13 years ago)
PAC ID
3476095654
Group Practice PAC ID
5092627000
Professional Enrollment ID
I20240603003174
Address ID
MN551304400SA402XXSXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for PETER O'MALIA (LICSW)

  • 4421 14TH AVE S

    MINNEAPOLIS, MN 554073642

    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: 2024-06-03

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
I20240603003174IClinical Social WorkerMNTBD

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 55407)

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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: 5092627000View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Nurse PractitionerMN
-MN
Clinical PsychologistMN
Nurse PractitionerMN
Clinical Social WorkerMN
P S Y C H I A T R YMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
-MN

Reviews

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Frequently asked questions

What is the 10-digit NPI for PETER O'MALIA (LICSW)?
PETER O'MALIA (LICSW) — NPI 1326893587 — is the standard way to identify this listing.
Is PETER O'MALIA (LICSW) still practicing?
PETER O'MALIA (LICSW) is currently listed as active in the public NPI registry.
What is PETER O'MALIA (LICSW)'s primary classification?
Clinical Social Worker is the headline specialty for PETER O'MALIA (LICSW) here. Clinical services aligned with this taxonomy classification.
What address line appears for PETER O'MALIA (LICSW)?
PETER O'MALIA (LICSW)'s geographic hint is Minneapolis, Minnesota in our summary view.
Why does PETER O'MALIA (LICSW) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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