Individual provider Active NPI

Tom Anthony Moreno, OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1598416760
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT23138 Issued in CA
Practice address
7575 Linda Vista Rd Apt 40
San Diego, CA 92111-5322
Phone
(559) 761-2138
NPI assigned
Jan 10, 2022
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 OT23138 CA Primary

Addresses

Primary practice location

7575 Linda Vista Rd Apt 40
San Diego, CA 92111-5322

Mailing address

7575 Linda Vista Rd Apt 40
San Diego, CA 92111-5322
Phone (559) 761-2138

Other practice location 1

3420 College Ave
San Diego, CA 92115-7134
Phone (619) 515-2445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250508001568 CA Practitioner - Occupational Therapist in Private Practice 6709303159 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT23138CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Apr 14, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Apr 14, 2025 Accepting new patients

Locations

3420 College Ave
San Diego, CA 92115
Phone (619) 515-2340

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

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, 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": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1598416760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 LINDA VISTA RD APT 40",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115322",
            "telephone_number": "559-761-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 LINDA VISTA RD APT 40",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115322",
            "telephone_number": "559-761-2138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3420 College Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921157134",
            "country_code": "US",
            "telephone_number": "619-515-2445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "TOM",
        "middle_name": "ANTHONY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT23138",
            "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 Apr 15, 2025; 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.