MICHAEL S MAZAK (OTR) – Occupational Therapist, NPI 1891994364

MICHAEL S MAZAK (OTR) is a healthcare provider. based in Willoughby, Ohio. specializing in Occupational Therapist. They hold the professional credentials OTR. They hold a License No. OT-5497 (OH). The NPI Number for MICHAEL S MAZAK (OTR) is 1891994364

Main info

Male
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL S MAZAK (OTR)
NPI
1891994364
Phone
(216) 645-7242
Address
PO BOX 1086
Enumeration Date
16 July 2007
Last Update Date
24 November 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4195244700
Graduation Year
2001 (25 years ago)
PAC ID
8123253036
Group Practice PAC ID
0547585085
Professional Enrollment ID
I20131101000192
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for MICHAEL S MAZAK (OTR)

  • PO BOX 1086

    WILLOUGHBY, OH 440961086

    Phone: (216) 645-7242

    Type: Mailing

  • Wellspring Custom Pharmacy, 2291, West 4th Street, Ontario, Springfield Township, Richland County, Ohio, 44906, United States

    SUITE D

    ONTARIO, OH 449061261

    Phone: (419) 589-2238

    Type: Location

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: 2013-11-01

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
I20131101000192IOccupational Therapist In Private PracticeOHTBD

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 44096)

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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: 0547585085View full group profile

Reviews

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Frequently asked questions

Can I cross-check MICHAEL S MAZAK (OTR) using NPI 1891994364?
NPI 1891994364 belongs to MICHAEL S MAZAK (OTR); compare other details if you need extra assurance.
Is MICHAEL S MAZAK (OTR) shown as active in public data?
Registry records indicate MICHAEL S MAZAK (OTR) maintains an active NPI.
What kind of doctor is MICHAEL S MAZAK (OTR)?
MICHAEL S MAZAK (OTR) is associated with Occupational Therapist in the directory — Clinical services aligned with this taxonomy classification.
Where in Ohio is MICHAEL S MAZAK (OTR) registered?
Use Willoughby, Ohio as the headline location for MICHAEL S MAZAK (OTR) here.
When was this NPI issued?
Enumeration for MICHAEL S MAZAK (OTR) is noted as July 16, 2007 where the registry provides it.

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