Individual provider Active NPI

Angela J Witucki, O.T.

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1477503514
Registry record updated Oct 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 3375 Issued in CA
Practice address
9988 Hibert St Ste 208
San Diego, CA 92131-2480
Phone
(858) 227-7229
Fax
(858) 221-4177
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2024

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 OT 3375 CA Primary

Addresses

Primary practice location

9988 Hibert St Ste 208
San Diego, CA 92131-2480

Mailing address

1965 5TH Ave
Ste 170
San Diego, CA 92101-2300
Phone (619) 851-6072

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627001284 CA Practitioner - Occupational Therapist in Private Practice 6204871593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

16950 Via Tazon
San Diego, CA 92127-1607
Phone (858) 499-2600

480 H St
Chula Vista, CA 91910-4328
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 3375CAMDOccupational Therapist
3375CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 14, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 14, 2023 Accepting new patients
Mission Occupational and Hand Therapy Services Apc CurrentSince Feb 16, 2026 Accepting new patients

Locations

9988 Hibert St
Ste 208
San Diego, CA 92131
Phone (858) 227-7229

9610 Granite Ridge Dr
San Diego, CA 92123
Phone (858) 505-5400

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728777600000",
    "number": "1477503514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 5TH AVE",
            "address_2": "STE 170",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012300",
            "telephone_number": "619-851-6072",
            "fax_number": "619-241-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9988 HIBERT ST STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312480",
            "telephone_number": "858-227-7229",
            "fax_number": "858-221-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITUCKI",
        "first_name": "ANGELA",
        "middle_name": "J",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 3375",
            "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 Oct 13, 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.