Jacqueline Sue Maroun, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT13853 Issued in CA

Practice address

24551 Raymond Way, #265
Lake Forest, CA 92630

Phone

(949) 305-8200

Fax

(949) 305-2211

NPI assigned

May 4, 2006

Last updated

Jan 10, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Michigan Medical School, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advantage Physical Therapy

  • Physical Therapist
  • Lake Forest, CA
  • NPI 1689716128
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1053369843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22865 LOUMONT DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303936",
            "telephone_number": "949-305-8200",
            "fax_number": "949-305-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24551 RAYMOND WAY, #265",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "92630",
            "telephone_number": "949-305-8200",
            "fax_number": "949-305-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROUN",
        "first_name": "JACQUELINE",
        "middle_name": "SUE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Elaine Mann
• Christian Oliver Manrubia
• Abbyella Mao
• Margaret's Villa, Inc.
• Karen R Marley, LMFT
• Marque Medical Clinic, Inc (Marque Urgent Care)
• Kristy Jacqueline Marrow
• Annika Marshall
• Jeffrey Marta
• Anne Louise Martin, MA MFT

• Physical Therapist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.