ANDREW WAGNER – Hand Occupational Therapist, NPI 1073900320
Hand Occupational Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
223 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in OR
Provider Addresses for ANDREW WAGNER
3415 SE POWELL BLVD
PORTLAND, OR 972023371
Phone: (503) 234-9591
Type: Mailing
24076 SE STARK ST STE 200
GRESHAM, OR 970303376
Phone: (503) 674-7860
Type: Mailing
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.
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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: 2022-12-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221212000184 | I | Occupational Therapist In Private Practice | OR | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97530 | Therapy procedure using functional activities | 221 | 19 | $0 |
| 97165 | Evaluation for occupational therapy, typically 30 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 97202)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | OR | |
| Occupational Therapist In Private Practice | NV | |
| Physical Therapist In Private Practice | OR | |
| Occupational Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | CA | |
| Physical Therapist In Private Practice | OR | |
| Occupational Therapist In Private Practice | AZ | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR |
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