Pacific Avenue Hand Therapy – Clinic/Center, NPI 1548416001

Pacific Avenue Hand Therapy is a healthcare provider. based in Mill creek, Washington. specializing in Clinic/Center. The NPI Number for Pacific Avenue Hand Therapy is 1548416001

Main info

Organization
Name
Pacific Avenue Hand Therapy
NPI
1548416001
Phone
(425) 316-8046
Address
4220 132ND ST SE
Authorized Official
MICHAEL SHANNON O'KELLEY PRESIDENT/OWNER MPT
Enumeration Date
14 August 2008
Last Update Date
22 October 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness80
Years active:17State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Pacific Avenue Hand Therapy

  • 4220, 132nd Street Southeast, Mill Creek, Snohomish County, Washington, 98012, United States

    SUITE 101

    MILL CREEK, WA 980128999

    Phone: (425) 316-8046

    Fax: (425) 338-9637

    Type: Mailing

  • 3732, Colby Avenue, Everett, Snohomish County, Washington, 98201, United States

    EVERETT, WA 982014911

    Phone: (425) 374-2846

    Fax: (425) 374-3272

    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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (587 days ago).

Enrollment records

1

Earliest due date

2024-10-31

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
O20100930086878OIndependently-Practicing Occupational TherapistWA2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98012)

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Reviews

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Frequently asked questions

Can I verify Pacific Avenue Hand Therapy with an NPI only?
You can start verification with NPI 1548416001 for Pacific Avenue Hand Therapy, then check state licensing separately.
Can I rely on Pacific Avenue Hand Therapy being an active provider?
As of the registry snapshot, Pacific Avenue Hand Therapy is marked active.
What is Pacific Avenue Hand Therapy's primary classification?
Clinic/Center is the headline specialty for Pacific Avenue Hand Therapy here. Clinical services aligned with this taxonomy classification.
Does Pacific Avenue Hand Therapy list a practice location?
Patients near Mill Creek, Washington may find Pacific Avenue Hand Therapy in results; validate coverage separately.
Is the information about Pacific Avenue Hand Therapy up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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