MITCHELL KANNAL – Physical Therapist, NPI 1255082350

MITCHELL KANNAL is a healthcare provider. based in Oconomowoc, Wisconsin. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 13543-24 (WI). The NPI Number for MITCHELL KANNAL is 1255082350

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MITCHELL KANNAL
NPI
1255082350
Phone
Not provided
Address
N683 NORTH AVE
Enumeration Date
11 January 2022
Last Update Date
9 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2622535060
Graduation Year
2016 (10 years ago)
PAC ID
5496140238
Group Practice PAC ID
3678760063
Professional Enrollment ID
I20220315000746
Address ID
WI530223239GEW168NAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Digital endpointsOther names

2,000 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WI

Provider Addresses for MITCHELL KANNAL

  • N683 NORTH AVE

    OCONOMOWOC, WI 530669315

    Phone:

    Type: Mailing

  • 1701 FOND DU LAC AVE

    KEWASKUM, WI 530409129

    Phone: (262) 626-4616

    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: 2022-03-15

PECOS data refreshed: 2026-06-15

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
I20220315000746IPhysical Therapist In Private PracticeWITBD

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 minutes99666$0
97140Therapy procedure using manual technique, each 15 minutes7027$0
97161Evaluation for physical therapy, typically 20 minutes5553$0
View full utilization report →

Insurance plans in this area (ZIP 53066)

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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: 3678760063View full group profile
NameSpecialtyState
-WI
-WI
Diagnostic RadiologyWI
Family Practice, Emergency MedicineWI
P S Y C H I A T R YWI
Internal MedicineWI
-WI
-WI
Rheumatology, Internal MedicineWI
Physical Therapist In Private PracticeWI

Reviews

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Frequently asked questions

Does MITCHELL KANNAL share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MITCHELL KANNAL uses 1255082350.
Does the file indicate MITCHELL KANNAL is practicing under active NPI?
Directory data currently reports MITCHELL KANNAL as active.
What taxonomy line describes MITCHELL KANNAL?
For research purposes, treat MITCHELL KANNAL as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does MITCHELL KANNAL list a practice location?
Patients near Oconomowoc, Wisconsin may find MITCHELL KANNAL in results; validate coverage separately.
Why does MITCHELL KANNAL have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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