Individual provider Active NPI

Adaina M Hansen, OTR

  • Physical Rehabilitation Occupational Therapist
  • Oceanside, CA
National Provider Identifier
1477869394
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
916618 Issued in CA
Practice address
2111 S El Camino Real
Ste 200
Oceanside, CA 92054-9000
Phone
(760) 729-5433
NPI assigned
Aug 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 916618 CA Primary

Addresses

Primary practice location

2111 S El Camino Real
Ste 200
Oceanside, CA 92054-9000

Mailing address

2111 S El Camino Real
Ste 200
Oceanside, CA 92054-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Physical Therapy CA PC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204003692 CA Practitioner - Occupational Therapist in Private Practice 5092241794 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2675CAMDCognitive & Behavioral Psychologist
916618CAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Ca PC CurrentSince Sep 7, 2024 Accepting new patients
Active Life Rehab, Inc. Past Accepting new patients

Locations

16868 Via del Campo Ct
Ste 100
San Diego, CA 92127
Phone (858) 239-8469

95 Duesenberg Dr
Westlake Village, CA 91362
Phone (805) 413-3300

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1477869394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 S EL CAMINO REAL",
            "address_2": "STE 200",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920549000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 S EL CAMINO REAL",
            "address_2": "STE 200",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920549000",
            "telephone_number": "760-729-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "ADAINA",
        "middle_name": "M",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "916618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Physical Therapy CA PC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "16868 Via Del Campo Ct Ste 100",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921271772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.