Individual provider Active NPI

Marilyn Chavez

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1063656528
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
37423 Issued in NU
Practice address
21355 Town Lakes Dr Apt 1413
Boca Raton, FL 33486-8886
Phone
(917) 697-2976
NPI assigned
Apr 28, 2009
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 37423 NU Primary
Community Health Worker 172V00000X 022278-1 NY

Addresses

Primary practice location

21355 Town Lakes Dr Apt 1413
Boca Raton, FL 33486-8886

Mailing address

21355 Town Lakes Dr Apt 1413
Boca Raton, FL 33486-8886
Phone (917) 697-2976

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118003075 FL Practitioner - Physical Therapist in Private Practice 9931418100 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Movement Therapy Center-Boynton Beach IncGroup PAC ID 1759464837, 17 clinicians

Practice addresses (Care Compare)

12040 S Jog Rd
Suite 8
Boynton Beach, FL 33437-4164
Phone (561) 733-5083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022278-1NYMDCommunity Health Worker
022278NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yk Physical Therapy Inc Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients

Locations

1874 W Hillsboro Blvd
Ste F
Deerfield Beach, FL 33442
Phone (954) 426-4544

220 S Dixie Hwy
Ste 4
Lake Worth Beach, FL 33460
Phone (561) 429-5086

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1063656528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21355 TOWN LAKES DR APT 1413",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334868886",
            "telephone_number": "917-697-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21355 TOWN LAKES DR APT 1413",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334868886",
            "telephone_number": "917-697-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "MARILYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": "37423",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "022278-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.