Individual provider Active NPI

Mike Marsh, OTR/L, CHT

  • Hand Occupational Therapist
  • San Leandro, CA
National Provider Identifier
1437120938
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT 2257 Issued in CA
Practice address
13690 E 14TH St
Suite# 200
San Leandro, CA 94578-2582
Phone
(510) 895-5511
Fax
(510) 895-5513
NPI assigned
Feb 1, 2006
Last updated
May 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT 2257 CA Primary

Addresses

Primary practice location

13690 E 14TH St
Suite# 200
San Leandro, CA 94578-2582

Mailing address

13690 E 14TH St
Suite# 200
San Leandro, CA 94578-2582
Phone (510) 895-5511

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ04670ZOtherCABLUESHIELD PROVIDER #
ZZZ31100ZOtherCAPROVIDER TRANSACTION ACCESS NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041027000701 CA Practitioner - Occupational Therapist in Private Practice 7618939299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay Hand Medical Center, IncGroup PAC ID 6608124284, 4 clinicians

Practice addresses (Care Compare)

13690 E 14TH St
Suite 200
San Leandro, CA 94578-2584
Phone 51029705504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 2257CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Hand Medical Center, Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

13690 E 14th St
Ste 200
San Leandro, CA 94578
Phone (510) 297-0550

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1437120938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13690 E 14TH ST",
            "address_2": "SUITE# 200",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782582",
            "telephone_number": "510-895-5511",
            "fax_number": "510-895-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13690 E 14TH ST",
            "address_2": "SUITE# 200",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782582",
            "telephone_number": "510-895-5511",
            "fax_number": "510-895-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "MIKE",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT 2257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD PROVIDER #",
            "identifier": "ZZZ04670Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "ZZZ31100Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.