Individual provider Active NPI

Samantha Yo, OTR/L

  • Occupational Therapist
  • Marina del Rey, CA
National Provider Identifier
1740878743
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
23061 Issued in CA
Practice address
4640 Admiralty Way Ste 420
Marina del Rey, CA 90292-6617
Phone
(424) 526-5151
Fax
(424) 835-6475
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Occupational Therapist 225X00000X 23061 CA Primary

Addresses

Primary practice location

4640 Admiralty Way Ste 420
Marina del Rey, CA 90292-6617

Mailing address

4640 Admiralty Way Ste 420
Marina del Rey, CA 90292-6617
Phone (424) 526-5151

Other identifiers 1

IdentifierTypeStateIssuer
23061OtherCASTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220830003266 CA Practitioner - Occupational Therapist in Private Practice 7012391758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

4640 Admiralty Way
Suite 420
Marina del Rey, CA 90292-6617
Phone (424) 526-5151

Merit-based Incentive Payment System (MIPS)

Final score
73.77 of 100Reported as group
Quality
31.85
Promoting interoperability
98
Improvement activities
40
Cost
82.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. CurrentSince Aug 15, 2024 Accepting new patients
Select CS Physical Therapy, P.C. Occupational Therapist Current Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Aug 15, 2024 Accepting new patients

Locations

4640 Admiralty Way
Ste 420
Marina del Rey, CA 90292
Phone (424) 526-5151

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1740878743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY STE 420",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926617",
            "telephone_number": "424-526-5151",
            "fax_number": "424-835-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY STE 420",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926617",
            "telephone_number": "424-526-5151",
            "fax_number": "424-835-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YO",
        "first_name": "SAMANTHA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "23061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "23061",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.