MICHELLE PETTIT (MA OTR/L) – Occupational Therapist, NPI 1760917710

MICHELLE PETTIT (MA OTR/L) is a healthcare provider. based in Anoka, Minnesota. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MA OTR/L. They hold a License No. 105290 (MN). The NPI Number for MICHELLE PETTIT (MA OTR/L) is 1760917710

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MICHELLE PETTIT (MA OTR/L)
NPI
1760917710
Phone
(763) 233-7274
Address
2829 VERNDALE AVE
Enumeration Date
27 April 2017
Last Update Date
27 April 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6013922097
Graduation Year
2016 (10 years ago)
PAC ID
2769813096
Group Practice PAC ID
4284027806
Professional Enrollment ID
I20200520002254
Address ID
MN55374XXXXROXXXXXXXXXX00
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

603 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MN

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Provider Addresses for MICHELLE PETTIT (MA OTR/L)

  • 2829, Verndale Avenue, Anoka, Anoka County, Minnesota, 55303, United States

    PEDIATRIC THERAPY DEPARTMENT

    ANOKA, MN 553031620

    Phone: (763) 233-7274

    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: 2020-05-20

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
I20200520002254IOccupational 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 55303)

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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: 4284027806View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeMN
Occupational Therapist In Private PracticeMN

Reviews

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Frequently asked questions

How do payers reference MICHELLE PETTIT (MA OTR/L)?
For MICHELLE PETTIT (MA OTR/L), use NPI 1760917710 as the unique 10-digit identifier.
Is there an active status for MICHELLE PETTIT (MA OTR/L)?
For scheduling context, MICHELLE PETTIT (MA OTR/L) is shown as active in the registry.
What clinical focus is listed for MICHELLE PETTIT (MA OTR/L)?
At a glance, MICHELLE PETTIT (MA OTR/L) is tied to Occupational Therapist. Clinical services aligned with this taxonomy classification.
Is MICHELLE PETTIT (MA OTR/L) located near Anoka?
MICHELLE PETTIT (MA OTR/L) currently maps to Anoka, Minnesota in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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