Individual provider Active NPI

Marcia A. Rebelo, LCSW

  • Clinical Social Worker
  • Encinitas, CA
National Provider Identifier
1649720566
Registry record updated Jun 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65679 Issued in CA
Practice address
187 Calle Magdalena Ste 114
Encinitas, CA 92024
Phone
(760) 846-1284
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 65679 CA Primary

Addresses

Primary practice location

187 Calle Magdalena Ste 114
Encinitas, CA 92024

Mailing address

1538 Encinitas Blvd
Encinitas, CA 92024-2932
Phone (760) 846-1284

Other practice location 1

187 Calle Magdalena Ste 107
Encinitas, CA 92024-3707
Phone (760) 846-1284

Other identifiers 3

IdentifierTypeStateIssuer
5612001OtherCACIGNA
100306587OtherCABLUE SHIELD
601147537OtherCAMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170525001439 CA Practitioner - Clinical Social Worker 5496022337 Practice locations: Encinitas, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

187 Calle Magdalena
Suite 212
Encinitas, CA 92024-3709
Phone (760) 846-1284

2631 Sausalito Ave
Carlsbad, CA 92010-7901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65679CAMDMedical Physician Assistant

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530316800000",
    "number": "1649720566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 ENCINITAS BLVD",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242932",
            "telephone_number": "760-846-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 CALLE MAGDALENA STE 114",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-846-1284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 Calle Magdalena Ste 107",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920243707",
            "country_code": "US",
            "telephone_number": "760-846-1284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REBELO",
        "first_name": "MARCIA",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2018-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "65679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5612001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "100306587",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "601147537",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.