Individual provider Active NPI

Dawn Lynn Marthis, OTR

  • Hand Occupational Therapist
  • San Clemente, CA
National Provider Identifier
1447466495
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
6567 Issued in CA
Practice address
653 Camino de Los Mares
Suite 110
San Clemente, CA 92673-2808
Phone
(949) 496-0122
Fax
(949) 496-5027
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 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 6567 CA Primary

Addresses

Primary practice location

653 Camino de Los Mares
Suite 110
San Clemente, CA 92673-2808

Mailing address

653 Camino de Los Mares
Suite 110
San Clemente, CA 92673-2808
Phone (949) 496-0122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000051 CA Practitioner - Occupational Therapist in Private Practice 0840352423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Arizona College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physical Therapy IncGroup PAC ID 3870987985, 5 clinicians

Practice addresses (Care Compare)

8996 Miramar Rd
Suite 315
San Diego, CA 92126-4463
Phone (619) 818-6873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6567CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physical Therapy Inc. CurrentSince Jun 1, 2022 Accepting new patients
Scor Physical Therapy Inc PastSince Dec 31, 1999 Accepting new patients

Locations

8996 Miramar Rd
Ste 315
San Diego, CA 92126
Phone (619) 818-6873

2751 Roosevelt Rd
Ste 203
San Diego, CA 92106
Phone (619) 501-9755

2650 Truxtun Rd
Ste 202
San Diego, CA 92106

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1447466495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES",
            "address_2": "SUITE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-496-0122",
            "fax_number": "949-496-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES",
            "address_2": "SUITE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-496-0122",
            "fax_number": "949-496-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTHIS",
        "first_name": "DAWN",
        "middle_name": "LYNN",
        "name_prefix": "Prof.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "6567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.