Active NPI
Baylee Rose Chelossi, OTR
- Occupational Therapist
- San Rafael, CA
National Provider Identifier
1881476430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT25664
- Practice address
- 4000 Civic Center Dr Ste 100
San Rafael, CA 94903-4151 - Phone
- (628) 877-0040
- NPI assigned
- Oct 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT25664 | CA | Primary |
Addresses
Primary practice location
4000 Civic Center Dr Ste 100
San Rafael, CA 94903-4151
Mailing address
1050 Court St Apt 513
San Rafael, CA 94901-2981
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT25664 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cortica Healthcare Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4
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.
-
- Health Service Clinic/Center
- San Diego, CA
- NPI 1801288535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1881476430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 COURT ST APT 513",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 CIVIC CENTER DR STE 100",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949034151",
"telephone_number": "628-877-0040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHELOSSI",
"first_name": "BAYLEE",
"middle_name": "ROSE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-18",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT25664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.