Individual provider Active NPI

Marissa Pazzaglia, OT

  • Occupational Therapist
  • Forest City, PA
National Provider Identifier
1295441160
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC017723 Issued in PA
Practice address
354 Main St
Forest City, PA 18421-1418
Phone
(570) 785-2018
NPI assigned
Jan 25, 2023
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC017723 PA Primary

Addresses

Primary practice location

354 Main St
Forest City, PA 18421-1418

Mailing address

354 Main St
Forest City, PA 18421-1418
Phone (570) 785-2018

Other identifiers 1

IdentifierTypeStateIssuer
OC017723OtherPALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230214000194 PA Practitioner - Occupational Therapist in Private Practice 6103298526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Physical Therapy IncGroup PAC ID 4981675709, 19 clinicians

Practice addresses (Care Compare)

19 Dundaff St
Carbondale, PA 18407-1828
Phone (570) 282-3302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC017723PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Physical Therapy, Inc Occupational Therapist CurrentSince Feb 20, 2023 Accepting new patients

Locations

1000 Meade St
Ste 208
Dunmore, PA 18512
Phone (570) 342-5333

354 Main St
Forest City, PA 18421
Phone (570) 785-2018

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1295441160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 MAIN ST",
            "city": "FOREST CITY",
            "state": "PA",
            "postal_code": "184211418",
            "telephone_number": "570-785-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 MAIN ST",
            "city": "FOREST CITY",
            "state": "PA",
            "postal_code": "184211418",
            "telephone_number": "570-785-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZZAGLIA",
        "first_name": "MARISSA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OC017723",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.