Marina Pavlenko, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61098335 Issued in WA

Practice address

110 110TH Ave NE Ste 110
Bellevue, WA 98004-5840

Phone

(425) 628-2072

Fax

(425) 341-9056

NPI assigned

Sep 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marina Kobylnik Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Everett Physical Therapy and Sport Performance Center PLLCGroup PAC ID 3779475181, 23 clinicians

Practice addresses (Care Compare)

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.

• Everett Physical Therapy and Sport Performance Center PLLC

  • Physical Therapist
  • Everett, WA
  • NPI 1699713370
  Medicare reassignment Care Compare group NPD
• Timberline Rehabilitation Service, PS

  • Physical Therapist
  • Vancouver, WA
  • NPI 1427237619
  Medicare reassignment NPD
• Everett Physical Therapy and Sport Performance Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bothell, WA
  • NPI 1447047477
  NPD
• Everett Physical Therapy and Sport Performance Center PLLC

  • Physical Therapist
  • Kirkland, WA
  • NPI 1003272675
  NPD (past)

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1275140279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 NE 112TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845114",
            "telephone_number": "360-567-2002",
            "fax_number": "360-567-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 110TH AVE NE STE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045840",
            "telephone_number": "425-628-2072",
            "fax_number": "425-341-9056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 NE 112th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986845114",
            "country_code": "US",
            "telephone_number": "360-567-2002",
            "fax_number": "360-567-2005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLENKO",
        "first_name": "MARINA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61098335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "KOBYLNIK",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jaycee Payne

• Physical Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.