Individual provider Active NPI

Marcus Belizaire, PT, DPT

  • Physical Therapist
  • Cumming, GA
National Provider Identifier
1013485499
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013754 Issued in GA
Practice address
4640 Martin Road
Cumming, GA 30041-5571
Phone
(678) 679-1261
Fax
(678) 250-9010
NPI assigned
Nov 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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 PT013754 GA Primary

Addresses

Primary practice location

4640 Martin Road
Cumming, GA 30041-5571

Mailing address

4640 Martin Road
Cumming, GA 30041-5571
Phone (678) 679-1261

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206003107 GA Practitioner - Physical Therapist in Private Practice 3779019278 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013754GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Essential Therapy Services, Inc. PastSince Oct 21, 2025 Accepting new patients
Essential Therapy Services Past Accepting new patients

Locations

966A Killian Hill Rd SW
Lilburn, GA 30047
Phone (770) 923-4815

150 Athens Hwy
Ste 600
Loganville, GA 30052
Phone (770) 554-2307

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": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1013485499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 MARTIN ROAD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415571",
            "telephone_number": "678-679-1261",
            "fax_number": "678-250-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 MARTIN ROAD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415571",
            "telephone_number": "678-679-1261",
            "fax_number": "678-250-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELIZAIRE",
        "first_name": "MARCUS",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.