YEVGENY EDD JOZEF MARABABOL MEDALLE OTR/L
NPI 1124885843
Occupational Therapist in Lakewood, CA

Active since February 29, 2024
3300 E SOUTH ST STE 203, LAKEWOOD, CA 90805(562) 512-3320 Get Directions Write a Review

NPPES record last updated: February 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Yevgeny Edd Jozef Marababol Medalle Otr/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YEVGENY EDD JOZEF MARABABOL MEDALLE OTR/L (NPI 1124885843) is an individual occupational therapist in Lakewood, California, licensed in California (25642) and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1124885843
Entity TypeIndividualMale
Primary Taxonomy225X00000X
Provider Legal NameYEVGENY EDD JOZEF MARABABOL MEDALLECredential: OTR/L
Location Address3300 E SOUTH ST STE 203Lakewood, CA 90805-4589
Mailing Address4308 E 4th St Apt 8Long Beach, CA 90814-4948 · (408) 250-4870
Sole ProprietorYes
Enumeration DateFebruary 29, 2024
NPPES CertifiedFebruary 29, 2024
✔ NPI 1124885843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in CA · 25642
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
3300 E SOUTH ST STE 203, Lakewood, CA 90805

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yevgeny Edd Jozef Marababol Medalle Otr/l is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Yevgeny Edd Jozef Medalle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapy
3300 E SOUTH ST STE 203
Lakewood, CA 90805
  • Reassigned Medicare billing, California enrollment
  • 10 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Physical Therapy)
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805
Physical Therapist
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805
Physical Therapy Assistant
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805
Physical Therapist
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805
Physical Therapist
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805
Physical Therapist
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805
Physical Therapy Assistant
3300 E SOUTH ST STE 203
LAKEWOOD, CA 90805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yevgeny Edd Jozef Medalle's NPI number?

The NPI number for Yevgeny Edd Jozef Medalle is 1124885843. It was assigned to this individual provider in the NPPES registry on February 29, 2024.

Where is Yevgeny Edd Jozef Medalle located?

Yevgeny Edd Jozef Medalle practices at 3300 E South St Ste 203, Lakewood, CA 90805. The listed phone number is (562) 512-3320.

What is Yevgeny Edd Jozef Medalle's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Yevgeny Edd Jozef Medalle enrolled in Medicare?

Yes. Yevgeny Edd Jozef Medalle is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Yevgeny Edd Jozef Medalle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Yevgeny Edd Jozef Medalle reassigns Medicare benefits to Functional Rehabilitation Physical Therapy PC (Lakewood, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Yevgeny Edd Jozef Medalle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Yevgeny Edd Jozef Medalle was last updated on February 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.