Active NPI
Samuel L Marabella Jr., PT
- Physical Therapist
- North Tonawanda, NY
National Provider Identifier
1225145394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 002388
- Practice address
- 105 Main St
North Tonawanda, NY 14120 - Phone
- (716) 692-6388
- Fax
- (716) 692-1227
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 002388 | NY | Primary |
Addresses
Primary practice location
105 Main St
North Tonawanda, NY 14120
Mailing address
105 Main St
North Tonawanda, NY 14120
Phone (716) 692-6388
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00020519201 | Other | UNIVERA | |
| 000604453001 | Other | BCBS | |
| 0066615 | Medicaid | NY | |
| 9351528 | Other | INDEPENDENT HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascend Physical Therapy Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopedic Physical Therapist
- Buffalo, NY
- NPI 1669425799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225145394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MAIN ST",
"city": "NORTH TONAWANDA",
"state": "NY",
"postal_code": "14120",
"telephone_number": "716-692-6388",
"fax_number": "716-692-1227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MAIN ST",
"city": "NORTH TONAWANDA",
"state": "NY",
"postal_code": "14120",
"telephone_number": "716-692-6388",
"fax_number": "716-692-1227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARABELLA",
"first_name": "SAMUEL",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "002388",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00020519201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000604453001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0066615",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "9351528",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in North Tonawanda, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.