Individual provider Active NPI

Rebecca Jacobs

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1730757857
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
22309 Issued in CA
Practice address
3959 Ruffin Rd Ste J
San Diego, CA 92123-1830
Phone
(858) 279-5570
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 22309 CA Primary

Addresses

Primary practice location

3959 Ruffin Rd Ste J
San Diego, CA 92123-1830

Mailing address

3959 Ruffin Rd Ste J
San Diego, CA 92123-1830
Phone (858) 279-5570

Other practice location 1

2732 Loker Ave W
Carlsbad, CA 92010-6603
Phone (760) 542-2414

Other identifiers 1

IdentifierTypeStateIssuer
22309OtherCAOT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210622003844 CA Practitioner - Occupational Therapist in Private Practice 7618378092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3959 Ruffin Rd
Suite J
San Diego, CA 92123-1830
Phone (858) 279-5570

Merit-based Incentive Payment System (MIPS)

Final score
74.62 of 100Reported as group
Quality
70
Improvement activities
40
Cost
70.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab United Sports Medicine & Physical Therapy, Inc. Multi-Specialty CurrentSince Jun 1, 2021 Accepting new patients
Rehab United Sports Medicine & Physical Therapy, Inc. CurrentSince Jun 1, 2021 Accepting new patients

Locations

2732 Loker Ave W
Carlsbad, CA 92010
Phone (760) 542-2414

5850 El Camino Real
Ste 111
Carlsbad, CA 92008
Phone (760) 542-2414

3959 Ruffin Rd
Ste J
San Diego, CA 92123
Phone (858) 279-5570

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1730757857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 RUFFIN RD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231830",
            "telephone_number": "858-279-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 RUFFIN RD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231830",
            "telephone_number": "858-279-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2732 Loker Ave W",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920106603",
            "country_code": "US",
            "telephone_number": "760-542-2414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "22309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "22309",
            "state": "CA"
        }
    ],
    "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 Jun 15, 2021; 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.