Individual provider Active NPI

Marisa J. Trottier

  • Physical Therapist
  • Kenosha, WI
National Provider Identifier
1578506192
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10471-024 Issued in WI
Practice address
3701 80TH St.
Kenosha, WI 53142
Phone
(262) 697-5290
Fax
(262) 697-1730
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10471-024 WI Primary
Physical Therapist 225100000X 070015133 IL

Addresses

Primary practice location

3701 80TH St.
Kenosha, WI 53142

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980

Other identifiers 1

IdentifierTypeStateIssuer
40464500MedicaidWI

Other names 1

  • Marisa J. Robinson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817001038 WI Practitioner - Physical Therapist in Private Practice 4981634029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone (262) 857-5300

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070015133ILMDPhysical Therapist
10471-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince May 6, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 6, 2020 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

10105 74th St
Ste 101
Kenosha, WI 53142
Phone (262) 697-5056

8500 75th St
Ste 105
Kenosha, WI 53142
Phone (847) 994-4195

3701 80th St
Kenosha, WI 53142
Phone (262) 697-1730

5708 75th St
#B
Kenosha, WI 53142
Phone (262) 697-9135

2615 N Downer Ave
Milwaukee, WI 53211
Phone (414) 962-4400

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

12500 Aurora Dr
Pleasant Prairie, WI 53158
Phone (262) 857-5000

Organizations & group practices 7

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1578506192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 80TH ST.",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-697-5290",
            "fax_number": "262-697-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTTIER",
        "first_name": "MARISA",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10471-024",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015133",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40464500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "ROBINSON",
            "middle_name": "J.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.