ANALIZA GAMBOA FAJARDO (OTR/L) – Gerontology Occupational Therapist, NPI 1659514560
Gerontology Occupational Therapist
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ANALIZA GAMBOA FAJARDO (OTR/L)
11595 Burnt Mill Rd
Jacksonville, FL 322563096
Phone: (904) 596-5000
Type: Location
414 OAKLAWN CT
SAINT AUGUSTINE, FL 320923591
Phone: (205) 572-0658
Type: Mailing
4500 SAN PABLO RD S
JACKSONVILLE, FL 322241865
Phone: (904) 953-2000
Type: Location
Old Springville Road, Spring Lake Estates, Birmingham, Jefferson County, Alabama, 35215, United States
SUITE 104
BIRMINGHAM, AL 352155858
Phone: (205) 572-0658
Type: Mailing
505, College Avenue, Ottawa, LaSalle County, Illinois, 61350, United States
OTTAWA, IL 613503865
Phone: (815) 433-1130
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: 2023-12-20
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 |
|---|---|---|---|---|
| I20231220000480 | I | Occupational Therapist In Private Practice | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32256)
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