Individual provider Active NPI

Marisa Olmo

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1588449466
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1369816 Issued in TX
Practice address
411 N Washington Ave
Dallas, TX 75246-1713
Phone
(945) 468-9009
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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 1369816 TX Primary

Addresses

Primary practice location

411 N Washington Ave
Dallas, TX 75246-1713

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

4015 Lemmon Ave
Dallas, TX 75219-3737
Phone (972) 979-6577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424002866 TX Practitioner - Physical Therapist in Private Practice 8426498452 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1369816TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Physical Therapy TX LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Orthotx, PLLC CurrentSince Mar 2, 2024 Accepting new patients
DPT Holdings, LLC Physical Therapist CurrentSince Sep 1, 2025 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince May 20, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

24014 W Renwick Rd
Ste 206
Plainfield, IL 60544

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

379 E FM 1382
Ste 100
Cedar Hill, TX 75104
Phone (972) 460-4490

5718 Spohn Dr
Ste 200
Corpus Christi, TX 78414
Phone (361) 906-2062

7999 W Virginia Dr
Ste D
Dallas, TX 75237
Phone (972) 709-6911

4015 Lemmon Ave
Dallas, TX 75219
Phone (469) 872-7461

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

3445 Golden Triangle Blvd
Ft Worth, TX 76177
Phone (817) 812-3007

8150 Highway 26
North Richlnd Hls, TX 76180
Phone (817) 349-2777

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1588449466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461713",
            "telephone_number": "945-468-9009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4015 Lemmon Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752193737",
            "country_code": "US",
            "telephone_number": "972-979-6577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLMO",
        "first_name": "MARISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1369816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.