Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARISSA IACULLO OT
NPI 1902795032
Occupational Therapist in San Diego, CA

Active since July 02, 2025Accepts Medicare Assignment
16868 VIA DEL CAMPO CT STE 100, SAN DIEGO, CA 92127(877) 407-3422(877) 407-4329 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 24, 2026, Jul 2, 2025 (2 updates tracked since 2025).

About Marissa Iacullo Ot NPPES

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

MARISSA IACULLO OT (NPI 1902795032) is an individual occupational therapist in San Diego, California, licensed in California (26459) and active in the NPI registry since July 2025. She is a graduate of Other (2022).

NPPES Registry Identity

NPI1902795032
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameMARISSA IACULLOCredential: OT
Location Address16868 VIA DEL CAMPO CT STE 100San Diego, CA 92127-1772
Mailing Address7 Carnegie PlzCherry Hill, NJ 08003-1000 · (877) 407-3422 · Fax (877) 407-4329
Fax(877) 407-4329
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 2, 2025
Last NPPES UpdateSeptember 24, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2026
✔ NPI 1902795032 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 · 26459
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.
16868 VIA DEL CAMPO CT STE 100, San Diego, CA 92127

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

Marissa Iacullo Ot 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.

PECOS PAC ID1254846546
PECOS Enrollment IDI20250715003959

Medicare Billing Reassignment

Medicare enrollment records show Marissa Iacullo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapist
16868 VIA DEL CAMPO CT STE 100
San Diego, CA 92127
  • Reassigned Medicare billing, California enrollment
  • 58 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 8

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

Occupational Therapist
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Speech-Language Pathologist
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Physical Therapist
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Occupational Therapist
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Psychiatry & Neurology (Psychiatry)
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Occupational Therapist
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Physical Therapist
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127
Psychiatry & Neurology (Psychiatry)
16868 VIA DEL CAMPO CT STE 100
SAN DIEGO, CA 92127

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 Marissa Iacullo's NPI number?

The NPI number for Marissa Iacullo is 1902795032. It was assigned to this individual provider in the NPPES registry on July 2, 2025.

Where is Marissa Iacullo located?

Marissa Iacullo practices at 16868 Via Del Campo Ct Ste 100, San Diego, CA 92127. The listed phone number is (877) 407-3422.

What is Marissa Iacullo's specialty?

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

Is Marissa Iacullo enrolled in Medicare?

Yes. Marissa Iacullo 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 Marissa Iacullo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marissa Iacullo reassigns Medicare benefits to Fox Rehabilitation Physical Therapy Ca PC (San Diego, 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 Marissa Iacullo'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 Marissa Iacullo was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days 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.