MCKENNA MACKINTOSH (DPT) – Orthopedic Physical Therapist, NPI 1477169001
Orthopedic Physical Therapist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA
Provider Addresses for MCKENNA MACKINTOSH (DPT)
109 S 65TH AVE STE 105
RIDGEFIELD, WA 986423408
Phone: (360) 309-6189
Fax: (360) 309-6193
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: 2020-11-04
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 |
|---|---|---|---|---|
| I20201104003141 | I | Physical Therapist In Private Practice | WA | 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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 429 | 14 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 215 | 12 | $0 |
Insurance plans in this area (ZIP 98642)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | WA |
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