Individual provider Active NPI

Andrea De Marino, MHS, OTR/L

  • Pediatric Occupational Therapist
  • Oceanside, CA
National Provider Identifier
1124149109
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT10597 Issued in CA
Practice address
835 S Coast Hwy
Oceanside, CA 92054-4122
Phone
(760) 444-4733
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 004431 GA
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X OT10597 CA Primary

Addresses

Primary practice location

835 S Coast Hwy
Oceanside, CA 92054-4122

Mailing address

2507 Willenhall Way
Lithonia, GA 30058-3884

Other practice location 1

1244 Clairmont Rd Ste 224
Decatur, GA 30030-1260
Phone (404) 728-9766 ext. 11

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004431GAMDOccupational Therapist
OT10597CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sensory Solutions Inc. Single Specialty PastSince Apr 21, 2013 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1124149109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 WILLENHALL WAY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300583884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S COAST HWY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544122",
            "telephone_number": "760-444-4733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1244 Clairmont Rd Ste 224",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300301260",
            "country_code": "US",
            "telephone_number": "404-728-9766 x11",
            "fax_number": "404-728-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE MARINO",
        "first_name": "ANDREA",
        "credential": "MHS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "004431",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT10597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.