Amanda Logan Marcic

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P23013 Issued in NC

Practice address

110 Canal St Ste 3
Lowell, MA 01852-4589

Phone

(888) 855-2674

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NJ, TX, NC, TN5 enrollments

Enrollment records 5

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Imago Rehab, IncGroup PAC ID 1850785056, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Imago Rehab, Inc

  • Neurorehabilitation Occupational Therapist
  • Lowell, MA
  • NPI 1205407236

  FL, NC, NJ, TN, TX

  Medicare reassignment Care Compare group
• Children'S Innovative Therapy

  • Speech-Language Pathologist
  • Angler, NC
  • NPI 1750404059
  NPD (past)
• Neuroscience Consultants LLP

  • Specialist
  • Medley, FL
  • NPI 1346217452
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1386256543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FOX DEN CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275139100",
            "telephone_number": "614-519-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CANAL ST STE 3",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524589",
            "telephone_number": "888-855-2674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9621 Bitter Melon Dr",
            "address_purpose": "LOCATION",
            "city": "Angier",
            "state": "NC",
            "postal_code": "275015917",
            "country_code": "US",
            "telephone_number": "919-275-9675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCIC",
        "first_name": "AMANDA",
        "middle_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "CP035261T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23013",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36121",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "CP037185T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "CP035282T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "CP035281T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeneta Mao
• Stephanie Marble, FNP
• Catherine Susan Marcelle
• Christina Marchio
• Mallory Anne Marchionda, RD, LDN
• Lauren A Marcotte
• Kathleen Marcoux
• Keri Ann Maresca, ATC, CSCS
• Juliet N Marimira
• Yaimarili Marin Avelino, M.S.,BCBA,LABA

• Physical Therapist in Lowell, MA
• Providers in Lowell, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.