Marissa E Plavchak

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI006075 Issued in PA

Practice address

580 Reed Rd Ste 3
Broomall, PA 19008-3655

Phone

(610) 356-6211

Fax

(610) 356-1429

NPI assigned

May 20, 2025

Last updated

May 20, 2025By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Physical Therapy and Wellness Institute LLC

  • Physical Therapist
  • Lansdale, PA
  • NPI 1740208339
  NPD (past)
• Progress Physical Therapy LLC

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1164851085
  NPD (past)

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1225820723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 BOULDER RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621813",
            "telephone_number": "412-874-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 REED RD STE 3",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083655",
            "telephone_number": "610-356-6211",
            "fax_number": "610-356-1429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2456 W Main St",
            "address_purpose": "LOCATION",
            "city": "West Norriton",
            "state": "PA",
            "postal_code": "194033066",
            "country_code": "US",
            "telephone_number": "610-630-0101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLAVCHAK",
        "first_name": "MARISSA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI006075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Peterson
• Patricia Baxter Petralia, O.T.
• Taylor Marie Phelps
• Pine View Healthcare LLC (Pine View Healthcare and Rehabilitation Center)
• Heidi Piselli, RBT
• Pma Medical Specialists (Prime Health Network)
• Abena Sarpong Poku
• David Pollack, MD
• Regina D Poole, NP
• Shana Rose Poole, RN

• Physical Therapy Assistant in Broomall, PA
• Providers in Broomall, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.