Individual provider Active NPI

Marissa Gigliotti, MS, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1376781641
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22893-1 Issued in NY
Practice address
21 Notre Dame Ave
Staten Island, NY 10308-2237
Phone
(917) 886-0104
NPI assigned
Jan 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

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 22893-1 NY Primary

Addresses

Primary practice location

21 Notre Dame Ave
Staten Island, NY 10308-2237

Mailing address

21 Notre Dame Ave
Staten Island, NY 10308-2237
Phone (917) 886-0104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22893-1NYMDPhysical Therapist
022893NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Leaps and Bounds Physical Therapy Physical Therapist Past Accepting new patients

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": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1376781641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 NOTRE DAME AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082237",
            "telephone_number": "917-886-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 NOTRE DAME AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082237",
            "telephone_number": "917-886-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIGLIOTTI",
        "first_name": "MARISSA",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "22893-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.