Individual provider Active NPI

Evan Joseph Marsh, PT, DPT

  • Physical Therapist
  • Malta, NY
National Provider Identifier
1134447014
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032590-1 Issued in NY
Practice address
7 Hemphill Place
Suite 130
Malta, NY 12020-4482
Phone
(518) 289-5242
Fax
(518) 289-5294
NPI assigned
May 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 032590 NY
Physical Therapist 225100000X 032590-1 NY Primary
Orthopedic Physical Therapist 2251X0800X 032590-1 NY

Addresses

Primary practice location

7 Hemphill Place
Suite 130
Malta, NY 12020-4482

Mailing address

7 Hemphill Place
Suite 130
Malta, NY 12020-4482
Phone (518) 289-5242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101217000010 NY Practitioner - Physical Therapist in Private Practice 5092903005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Area Physical Therapy PLLCGroup PAC ID 2264674324, 13 clinicians

Practice addresses (Care Compare)

345 Delaware Ave
Delmar, NY 12054-1920
Phone (518) 289-5242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032590NYMDProsthodontist
032590-1NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cocozzo Physical Therapy, PC Physical Therapist PastSince Apr 17, 2024 Accepting new patients

Organizations & group practices 2

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": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1134447014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HEMPHILL PLACE",
            "address_2": "SUITE 130",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204482",
            "telephone_number": "518-289-5242",
            "fax_number": "518-289-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HEMPHILL PLACE",
            "address_2": "SUITE 130",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204482",
            "telephone_number": "518-289-5242",
            "fax_number": "518-289-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "EVAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-17",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "032590",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032590-1",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "032590-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.