MARY UNDERWOOD (MA, CCC-SLP) – Speech-Language Pathologist, NPI 1083173637

MARY UNDERWOOD (MA, CCC-SLP) is a healthcare provider. based in Omaha, Nebraska. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials MA, CCC-SLP. They hold a License No. 633 (NE). The NPI Number for MARY UNDERWOOD (MA, CCC-SLP) is 1083173637

Main info

Female
Sole Proprietor
52 Years Of Experience
Accepts Medicare Assignment
Name
MARY UNDERWOOD (MA, CCC-SLP)
NPI
1083173637
Phone
(402) 658-9536
Address
10205 W ST
Enumeration Date
13 March 2019
Last Update Date
13 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4023915002
Graduation Year
1974 (52 years ago)
PAC ID
3274968078
Group Practice PAC ID
6800060856
Professional Enrollment ID
I20200125000187
Address ID
NE680054226BE1001XNXXX501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

124 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in NE

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Provider Addresses for MARY UNDERWOOD (MA, CCC-SLP)

  • 10205, W Street, Millard, Omaha, Douglas County, Nebraska, 68127, United States

    OMAHA, NE 681273043

    Phone: (402) 658-9536

    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: 2020-01-25

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
I20200125000187IQualified Speech Language PathologistNETBD

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
92507Treatment of speech, language, voice, communication, and/or hearing processing disorder8214$0
92524Analysis of voice and resonance production1111$0
View full utilization report →

Insurance plans in this area (ZIP 68127)

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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: 6800060856View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeNE
Qualified Speech Language PathologistNE
-NE
Qualified Speech Language PathologistIA
Occupational Therapist In Private PracticeNE
-NE
Occupational Therapist In Private PracticeNE
-NE
Physical Therapist In Private PracticeNE
Occupational Therapist In Private PracticeIA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARY UNDERWOOD (MA, CCC-SLP)?
MARY UNDERWOOD (MA, CCC-SLP) — NPI 1083173637 — is the standard way to identify this listing.
Does CMS list MARY UNDERWOOD (MA, CCC-SLP) as active?
Yes — MARY UNDERWOOD (MA, CCC-SLP) is active in the NPI listing used on this page.
What healthcare role does MARY UNDERWOOD (MA, CCC-SLP) hold?
Scheduling teams often label MARY UNDERWOOD (MA, CCC-SLP) under Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
Where is MARY UNDERWOOD (MA, CCC-SLP) based?
MARY UNDERWOOD (MA, CCC-SLP) is tied to Omaha, Nebraska in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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