MARY THERESE ETAYEB OTR
NPI 1790982858
Occupational Therapist - Hand in Los Angeles, CA
About Mary Therese Etayeb Otr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY THERESE ETAYEB OTR (NPI 1790982858) is an individual hand provider in Los Angeles, California, licensed in California (5942) and active in the NPI registry since June 2007. She is a graduate of Other (1986).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mary Therese Etayeb Otr is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Mary Etayeb reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90034
- Reassigned Medicare billing, California enrollment
- 13,921 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90034
LOS ANGELES, CA 90034
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 Mary Etayeb's NPI number?
The NPI number for Mary Etayeb is 1790982858. It was assigned to this individual provider in the NPPES registry on June 29, 2007.
Where is Mary Etayeb located?
Mary Etayeb practices at 6041 Cadillac Ave, Los Angeles, CA 90034. The listed phone number is (323) 857-2536.
What is Mary Etayeb's specialty?
The primary specialty registered for this NPI is Occupational Therapist, specializing in Hand, with taxonomy code 225XH1200X.
Is Mary Etayeb enrolled in Medicare?
Yes. Mary Etayeb is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mary Etayeb's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Etayeb reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, 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 Mary Etayeb'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 Mary Etayeb was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mary Therese Etayeb, OTR · NPI 1790982858
Hand provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since June 29, 2007.
## Identity
- **NPI:** 1790982858 (Entity type: Individual)
- **Enumerated:** June 29, 2007
- **Primary specialty:** Occupational Therapist - Hand · taxonomy 225XH1200X
- **State license:** 5942 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 6041 CADILLAC AVE, Los Angeles, CA 90034-1702
- **Phone:** (323) 857-2536 · **Fax:** (323) 857-3736
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1043242563, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1986
## Record status
- **NPPES last updated:** December 3, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1790982858) · Data from the CMS NPPES public registry.