Individual provider Active NPI

Marissa Elizabeth Moquin, DPT

  • Physical Therapist
  • Natick, MA
National Provider Identifier
1366112872
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25590 Issued in MA
Practice address
1 H F Brown Way
Natick, MA 01760-3889
Phone
(508) 647-1633
Fax
(508) 647-1634
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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 25590 MA Primary

Addresses

Primary practice location

1 H F Brown Way
Natick, MA 01760-3889

Mailing address

1 H F Brown Way
Natick, MA 01760-3889
Phone (508) 647-1633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012000459 MA Practitioner - Physical Therapist in Private Practice 6901204635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jump Start Physical Therapy, IncGroup PAC ID 0042295123, 12 clinicians

Practice addresses (Care Compare)

1 H F Brown Way
Natick, MA 01760-3889
Phone (508) 647-1633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jump Start Physical Therapy, Inc Physical Therapist CurrentSince Aug 30, 2021 Accepting new patients

Locations

1 H F Brown Way
Natick, MA 01760
Phone (508) 647-1633

290 Vanderbilt Ave
Ste 5
Norwood, MA 02062
Phone (781) 349-8235

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.

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1366112872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 H F BROWN WAY",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017603889",
            "telephone_number": "508-647-1633",
            "fax_number": "508-647-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 H F BROWN WAY",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017603889",
            "telephone_number": "508-647-1633",
            "fax_number": "508-647-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOQUIN",
        "first_name": "MARISSA",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.