MR. MARK MYDAN (OTR/L) – Specialist, NPI 1104292499

MR. MARK MYDAN (OTR/L) is a healthcare provider. based in Bellingham, Washington. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. OT 60084951 (WA). The NPI Number for MR. MARK MYDAN (OTR/L) is 1104292499

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
MR. MARK MYDAN (OTR/L)
NPI
1104292499
Phone
(360) 595-8427
Address
544 MIDWOOD CT
Enumeration Date
20 August 2015
Last Update Date
20 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3603541115
Graduation Year
1993 (33 years ago)
PAC ID
7113234303
Group Practice PAC ID
0446414403
Professional Enrollment ID
I20150921002437
Address ID
WA982648800LY8862XRDXX303
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

460 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for MR. MARK MYDAN (OTR/L)

  • 544 MIDWOOD CT

    BELLINGHAM, WA 982297102

    Phone: (360) 595-8427

    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: 2015-09-21

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
I20150921002437IOccupational Therapist In Private PracticeWATBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes30953$0
97140Therapy procedure using manual technique, each 15 minutes11926$0
97535Training for self-care or home management, each 15 minutes10335$0
97165Evaluation for occupational therapy, typically 30 minutes5858$0
97760Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes4216$0
View full utilization report →

Insurance plans in this area (ZIP 98229)

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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: 0446414403View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeBRITISH COLUMBIA
-WA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. MARK MYDAN (OTR/L)?
MR. MARK MYDAN (OTR/L) — NPI 1104292499 — is the standard way to identify this listing.
Can I rely on MR. MARK MYDAN (OTR/L) being an active provider?
As of the registry snapshot, MR. MARK MYDAN (OTR/L) is marked active.
What is MR. MARK MYDAN (OTR/L) best known for clinically?
Directory data describes MR. MARK MYDAN (OTR/L) with Other Service Providers. Clinical services aligned with this taxonomy classification.
Where is MR. MARK MYDAN (OTR/L) based?
MR. MARK MYDAN (OTR/L) is tied to Bellingham, Washington in the data we show; additional addresses may exist on the full record.
Why does MR. MARK MYDAN (OTR/L) 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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