MITTEN STATE PEDIATRIC THERAPY LLC
NPI 1063021715
Occupational Therapist in Grand Rapids, MI

Active since July 29, 2020
5258 PLAINFIELD AVE NE STE A, GRAND RAPIDS, MI 49525(616) 466-4068(616) 369-1646 Get Directions Write a Review

NPPES record last updated: September 11, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mitten State Pediatric Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITTEN STATE PEDIATRIC THERAPY LLC (NPI 1063021715) is a healthcare organization registered as an occupational therapist in Grand Rapids, Michigan and active in the NPI registry since July 2020. The organization lists Lindsay Dammar, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1063021715
Entity TypeOrganization
Primary Taxonomy225X00000X
Legal Business NameMITTEN STATE PEDIATRIC THERAPY LLC
Location Address5258 PLAINFIELD AVE NE STE AGrand Rapids, MI 49525-1092
Mailing Address6659 Craftsman Square Dr NeRockford, MI 49341-8861 · (248) 535-4666
Fax(616) 369-1646
Organization SubpartNo
Authorized OfficialLindsay DammarCo-owner · (248) 535-4666
Enumeration DateJuly 29, 2020
Last NPPES UpdateSeptember 11, 2023
NPPES CertifiedSeptember 11, 2023
✔ NPI 1063021715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
5258 PLAINFIELD AVE NE STE A, Grand Rapids, MI 49525

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mitten State Pediatric Therapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Mitten State Pediatric Therapy LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Physical Therapist in Private Practice
NPI 1013792738
5258 PLAINFIELD AVE NE
Grand Rapids, MI 49525
(616) 719-0490
Same address
Occupational Therapist in Private Practice
NPI 1629946728
5258 PLAINFIELD AVE NE STE A
Grand Rapids, MI 49525
(616) 719-0490
Same address
Physical Therapist in Private Practice
NPI 1467955765
35 MICHIGAN ST NE STE 5301
Grand Rapids, MI 49503
(616) 391-8842
7.1 mi
Occupational Therapist in Private Practice
NPI 1346743465
4118 KALAMAZOO AVE SE
Grand Rapids, MI 49508
(616) 827-5981
12 mi
Occupational Therapist in Private Practice
NPI 1386365039
16760 LINCOLN ST
Grand Haven, MI 49417
(616) 935-3300
31 mi
Qualified Speech Language Pathologist
NPI 1891421616
16760 LINCOLN ST
Grand Haven, MI 49417
(616) 935-3300
31 mi
Qualified Speech Language Pathologist
NPI 1770264483
5205 COMMONWEALTH CENTRE PKWY
Midlothian, VA 23112
(804) 977-2770
573 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitten State Pediatric Therapy LLC's NPI number?

The NPI number for Mitten State Pediatric Therapy LLC is 1063021715. It was assigned to this organization in the NPPES registry on July 29, 2020.

Where is Mitten State Pediatric Therapy LLC located?

Mitten State Pediatric Therapy LLC is located at 5258 Plainfield Ave NE Ste A, Grand Rapids, MI 49525. The listed phone number is (616) 466-4068.

What is Mitten State Pediatric Therapy LLC's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Mitten State Pediatric Therapy LLC enrolled in Medicare?

Yes. Mitten State Pediatric Therapy LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mitten State Pediatric Therapy LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Mitten State Pediatric Therapy LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Occupational Therapist in Private Practice (3), Physical Therapist in Private Practice (2) and Qualified Speech Language Pathologist (2). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mitten State Pediatric Therapy LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Mitten State Pediatric Therapy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mitten State Pediatric Therapy LLC was last updated on September 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.