Individual provider Active NPI

Maureen Neill Meehan, OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1821388349
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5747 Issued in CA
Practice address
235 Nutmeg St
San Diego, CA 92103-6201
Phone
(619) 846-7443
Fax
(252) 457-0540
NPI assigned
Apr 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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 5747 CA Primary

Addresses

Primary practice location

235 Nutmeg St
San Diego, CA 92103-6201

Mailing address

235 Nutmeg St
San Diego, CA 92103-6201
Phone (619) 846-7443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703001269 CA Practitioner - Occupational Therapist in Private Practice 5890154280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Life Physical Therapy Services PCGroup PAC ID 7214207125, 94 clinicians

Practice addresses (Care Compare)

12515 Springhurst Dr
San Diego, CA 92128-6305
Phone (858) 771-3694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5747CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC Occupational Therapist CurrentSince May 23, 2023 Accepting new patients

Locations

12515 Springhurst Dr
San Diego, CA 92128
Phone (858) 771-3694

Organizations & group practices 1

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1821388349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 NUTMEG ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036201",
            "telephone_number": "619-846-7443",
            "fax_number": "252-457-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 NUTMEG ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036201",
            "telephone_number": "619-846-7443",
            "fax_number": "252-457-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "MAUREEN",
        "middle_name": "NEILL",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "5747",
            "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 Jun 23, 2022; 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.