Marissa Gill, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20353 Issued in MA

Practice address

375 Faunce Corner Rd Ste C
North Dartmouth, MA 02747-1258

Phone

(781) 425-7906

Fax

(774) 221-2209

NPI assigned

Jan 25, 2013

Last updated

Jul 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bay State Physical Therapy of Randolph Inc

  dba Bay State Physical Therapy

  • Physical Therapist
  • Fall River, MA
  • NPI 1164474334
  Medicare reassignment Care Compare group
• Bay State Physical Therapy of Randolph Inc

  dba Bay State Physical Therapy

  • Physical Therapist
  • Brockton, MA
  • NPI 1740390459
  NPD

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1477891463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY FL 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 FAUNCE CORNER RD STE C",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471258",
            "telephone_number": "781-425-7906",
            "fax_number": "774-221-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 New State Hwy",
            "address_purpose": "LOCATION",
            "city": "Raynham",
            "state": "MA",
            "postal_code": "02767",
            "country_code": "US",
            "telephone_number": "508-824-6800",
            "fax_number": "508-386-0585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "MARISSA",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110010076A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan C Garrity, NP
• Lori Lee Georgeson, MD
• Geriatric Internal Medicine Specialists, LLC
• Sean Amir Ghassem-Zadeh, D.M.D.
• Taha Ghomi
• David L Gillespie, MD
• Craig Alexander Gimler
• Debra Rachel Gold
• Arthur M. Goldman, O.D.
• Enya Gomes

• Physical Therapist in North Dartmouth, MA
• Providers in North Dartmouth, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.