Maryalicia Grassano, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2305209667 Issued in VA

Practice address

968 First Colonial Rd
Suite 101
Virginia Beach, VA 23454-3171

Phone

(757) 412-1005

Fax

(757) 412-1015

NPI assigned

Aug 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Maryalicia Kohut Other name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 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 and National Provider Directory roles.

• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433
  Medicare reassignment Care Compare group NPD
• Ivyrehab Sept, LLC

  • Physical Medicine & Rehabilitation Physician
  • Verona, VA
  • NPI 1235955709

  Physical Therapist

  NPD

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1538545108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307 SUITE 101",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022413171",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 FIRST COLONIAL RD",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543171",
            "telephone_number": "757-412-1005",
            "fax_number": "757-412-1015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4668 Pembroke Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234556423",
            "country_code": "US",
            "telephone_number": "757-932-4261",
            "fax_number": "757-648-8564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRASSANO",
        "first_name": "MARYALICIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209667",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305209667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYALICIA",
            "last_name": "KOHUT",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jason William Grant
• Keshara Myrnae Grant
• Laurie Grant, LCSW
• Lynette Anita Grant, RPH
• William P Grant, D.P.M.
• Susanne NG Grasso, MD
• Gratitude Individual & Family Therapy Services
• Kathryn Mandell Grau, DPT
• Markisha Gravely, MA, LPC
• Cecilia E Graves, RESIDENT LPC

• Orthopedic Physical Therapist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Orthopedic Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.