Marietta Joanne Phillips, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012008-1 Issued in NY

Practice address

2755 Buffalo Rd
Rochester, NY 14624-1304

Phone

(585) 290-1490

NPI assigned

Feb 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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 and National Provider Directory roles.

• Sprout Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Rochester, NY
  • NPI 1225825193

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Shuman Physical Therapy Associates, P.C.

  • Physical Therapist
  • Rochester, NY
  • NPI 1003928755
  NPD

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1104960343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TELLIDORA TRL",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145599404",
            "telephone_number": "585-293-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 BUFFALO RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241304",
            "telephone_number": "585-290-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1299 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146212730",
            "country_code": "US",
            "telephone_number": "585-266-4694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARIETTA",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012008-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Russell Phillips, MT-BC, NMT
• Jinnah Alexandra Phillips, MD
• Kara Phillips, CASAC
• Lindsay Phillips, M.D.
• Lindsey Ann Phillips, L.P.N
• Michelle A Phillips, PHARMD
• Roslyn Marie Phillips, MHC, CASAC-T
• Stacy J Phillips, MS OTR/L
• Stephen Phillips, DMD
• Valerie J Phillips, PA-C

• Physical Therapist in Rochester, NY
• Providers in Rochester, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.