Mallory Alice Vig, OTR is a medicare enrolled "Occupational Therapist" provider in Fosston, Minnesota. She graduated from medical school in 2018 and has 8 years of diverse experience with area of expertise as Occupational Therapist In Private Practice. She is a member of the group practice Pine Peak Therapy Llc and her current practice location is
103 W 1st St, Fosston, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 431-0009.
Mallory Alice Vig is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1376033357.
Healthcare Provider's Profile
| Full Name | Mallory Alice Vig |
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| Gender | Female |
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| Speciality | Occupational Therapist In Private Practice |
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| Experience | 8 Years |
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| Location | 103 W 1st St, Fosston, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mallory Alice Vig graduated from medical school in 2018
NPI Data:
- NPI Number: 1376033357
- Provider Enumeration Date: 05/15/2018
- Last Update Date: 06/10/2025
Medicare PECOS Information:
- PECOS PAC ID: 0143694737
- Enrollment ID: I20230322001510
Medical Identifiers
Medical identifiers for Mallory Alice Vig such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1376033357 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Pine Peak Therapy Llc | 8820447493 | 4 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mallory Alice Vig allows following entities to bill medicare on her behalf.
| Provider Name | Pine Peak Therapy Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1982477030 PECOS PAC ID: 8820447493 Enrollment ID: O20231207001962 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mallory Alice Vig is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mallory Alice Vig, OTR Po Box 300, Fosston, MN 56542-0300 Ph: (218) 435-1210 | Mallory Alice Vig, OTR 103 W 1st St, Fosston, MN 56542 Ph: (218) 431-0009 |
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