Mallory Alice Vig, OTR
NPI 1376033357ActiveIndividual· Occupational Therapist· Fosston, MN
Occupational Therapist (OTR) with Pine Peak Therapy LLC, practicing in Fosston, Minnesota. Medicare paid $5,494 for services to 13 patients in 2024.
Overview
| NPI | 1376033357 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OTR |
| Sole proprietor | No |
| NPI issued | May 15, 2018 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Occupational Therapist in Private Practice (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 13 |
|---|---|
| Services billed | 223 across 6 procedure codes |
| Paid by Medicare | $5,494 |
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Occupational Therapist In Private Practice |
Medical group
- Pine Peak Therapy LLCFosston, MN · 4 clinicians
Other Occupational Therapist providers in Fosston
- 1427659234