Individual provider Active NPI

Kosha Shah

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1326529918
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT16451 Issued in CA
Practice address
12071 Alta Carmel CT Unit 85
San Diego, CA 92128-3815
Phone
(443) 510-6841
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT16451 CA Primary

Addresses

Primary practice location

12071 Alta Carmel CT Unit 85
San Diego, CA 92128-3815

Mailing address

12071 Alta Carmel CT Unit 85
San Diego, CA 92128-3815
Phone (443) 510-6841

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220606000959 CA Practitioner - Occupational Therapist in Private Practice 0941688824 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT16451CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bewell Home Physical Therapy P C CurrentSince May 22, 2024 Accepting new patients
Mobile Therapy and Consulting Occupational Therapist CurrentSince May 1, 2022 Accepting new patients
Sabonjian Speech Services, Inc. Occupational Therapist PastSince Jul 1, 2013 Accepting new patients

Locations

1582 W San Marcos Blvd
Ste 105B
San Marcos, CA 92078
Phone (650) 452-4110

Organizations & group practices 3

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1326529918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12071 ALTA CARMEL CT UNIT 85",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283815",
            "telephone_number": "443-510-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12071 ALTA CARMEL CT UNIT 85",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283815",
            "telephone_number": "443-510-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KOSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT16451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.