Individual provider Active NPI

Marissa Schubert, D.P.T.

  • Physical Therapist
  • Santa Ana, CA
National Provider Identifier
1841564549
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 38809 Issued in CA
Practice address
2101 E 4TH St Ste 170
Santa Ana, CA 92705-3814
Phone
(714) 558-3977
Fax
(714) 558-0308
NPI assigned
Feb 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 38809 CA Primary

Addresses

Primary practice location

2101 E 4TH St Ste 170
Santa Ana, CA 92705-3814

Mailing address

200 Newport Center Dr
Newport Beach, CA 92660-7501
Phone (562) 777-1333

Other practice location 1

12555 Lakewood Blvd
Suite D
Downey, CA 90242-2771
Phone (562) 777-1333

Other practice location 2

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Other names 1

  • Marissa Carratello Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120712000340 CA Practitioner - Physical Therapist in Private Practice 6204091598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2101 E 4TH St
Suite 170
Santa Ana, CA 92705-3814
Phone (714) 558-3977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 38809CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist Current Accepting new patients
California Rehab & Sports Therapy CurrentSince Apr 1, 2012 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Oct 29, 2019 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist CurrentSince Apr 1, 2012 Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

12555 Lakewood Blvd
Ste D
Downey, CA 90242
Phone (562) 777-1333

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

2101 E 4th St
Ste 170
Santa Ana, CA 92705
Phone (714) 558-3977

2101 E 4th St
#170
Santa Ana, CA 92705
Phone (714) 558-3977

Organizations & group practices 4

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": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1841564549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "562-777-1333",
            "fax_number": "562-777-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E 4TH ST STE 170",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053814",
            "telephone_number": "714-558-3977",
            "fax_number": "714-558-0308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12555 Lakewood Blvd",
            "address_2": "Suite D",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902422771",
            "country_code": "US",
            "telephone_number": "562-777-1333",
            "fax_number": "562-777-1347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUBERT",
        "first_name": "MARISSA",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-28",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 38809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CARRATELLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.