Individual provider Active NPI

Marissa Lee Garvin, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1588330328
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61196301 Issued in WA
Practice address
5620 Rainier Ave S Ste 102
Seattle, WA 98118-2498
Phone
(206) 535-8061
Fax
(206) 535-8064
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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 PT61196301 WA Primary

Addresses

Primary practice location

5620 Rainier Ave S Ste 102
Seattle, WA 98118-2498

Mailing address

5620 Rainier Ave S Ste 102
Seattle, WA 98118-2498
Phone (206) 535-8061

Other identifiers 1

IdentifierTypeStateIssuer
PT61196301OtherWAPT LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Seattle Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211116002352 WA Practitioner - Physical Therapist in Private Practice 7416346267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Work Prevention and Physical Therapy IncGroup PAC ID 0446444624, 26 clinicians

Practice addresses (Care Compare)

5620 Rainier Ave S
Suite 102
Seattle, WA 98118-2498
Phone (206) 535-8061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT61196301WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Work Prevention & Physical Therapy, Inc. CurrentSince Nov 2, 2021 Accepting new patients

Locations

5620 Rainier Ave S
Ste 102
Seattle, WA 98118
Phone (206) 535-8061

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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1588330328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 RAINIER AVE S STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182498",
            "telephone_number": "206-535-8061",
            "fax_number": "206-535-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 RAINIER AVE S STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182498",
            "telephone_number": "206-535-8061",
            "fax_number": "206-535-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVIN",
        "first_name": "MARISSA",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61196301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT61196301",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Seattle",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5620 Rainier Ave S Ste 102",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981182498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.