MITTEN STATE PEDIATRIC THERAPY LLC
NPI 1063021715
Occupational Therapist in Grand Rapids, MI
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
Specialties & Licenses 4
Group Practice 1
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
7Medicare 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)
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.