Individual provider Active NPI

Jacob Lance Marino, PT, DPT

  • Physical Therapist
  • Golden, CO
National Provider Identifier
1316722044
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP044946T Issued in CO
Practice address
112 N Rubey Dr Unit 135
Golden, CO 80403-3214
Phone
(303) 279-7703
NPI assigned
Aug 30, 2023
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP044946T CO Primary

Addresses

Primary practice location

112 N Rubey Dr Unit 135
Golden, CO 80403-3214

Mailing address

112 N Rubey Dr Unit 135
Golden, CO 80403-3214

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016000247 LA Practitioner - Physical Therapist in Private Practice 1254786072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP044946TCOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiofit Physical Therapy, LLC Physical Therapist CurrentSince Sep 11, 2023 Accepting new patients
Physiofit Physical Therapy, LLC Physical Therapist CurrentSince Sep 11, 2023 Accepting new patients
Select Physical Therapy of West Denver Limited Partnership Past Accepting new patients
Theraphysics Partners of Colorado, Inc. Physical Therapist PastSince Jun 8, 2025 Accepting new patients
Theraphysics Partners of Colorado, Inc. Past Accepting new patients
Theraphysics Partners of Colorado, Inc. PastSince Jun 8, 2025 Accepting new patients
Select Physical Therapy of West Denver Limited Partnership Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

12627 Airline Hwy
Ste A
Destrehan, LA 70047
Phone (985) 603-4157

120 White Rose Dr
Raceland, LA 70394
Phone (985) 532-2229

Organizations & group practices 7

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": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1316722044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N RUBEY DR UNIT 135",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804033214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N RUBEY DR UNIT 135",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804033214",
            "telephone_number": "303-279-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "JACOB",
        "middle_name": "LANCE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-30",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP044946T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.