Individual provider Active NPI

Marissa Leigh Ho, PT, DPT

  • Physical Therapist
  • Cupertino, CA
National Provider Identifier
1124520473
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294125 Issued in CA
Practice address
20823 Stevens Creek Blvd Ste 200
Cupertino, CA 95014-2112
Phone
(408) 252-6076
NPI assigned
Mar 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294125 CA Primary

Addresses

Primary practice location

20823 Stevens Creek Blvd Ste 200
Cupertino, CA 95014-2112

Mailing address

20823 Stevens Creek Blvd Ste 200
Cupertino, CA 95014-2112

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180309001258 CA Practitioner - Physical Therapist in Private Practice 4385905223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Boston University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294125CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quinn Orthopedic Physical Therapy Physical Therapist CurrentSince Mar 6, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 15, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 15, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

20823 Stevens Creek Blvd
Ste 200
Cupertino, CA 95014
Phone (408) 252-6076

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4650 Palm Ave
San Diego, CA 92154
Phone (619) 662-5226

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1590 The Alameda
Ste 110
San Jose, CA 95126
Phone (408) 947-8466

Organizations & group practices 4

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": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1124520473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20823 STEVENS CREEK BLVD STE 200",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20823 STEVENS CREEK BLVD STE 200",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142112",
            "telephone_number": "408-252-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HO",
        "first_name": "MARISSA",
        "middle_name": "LEIGH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.