Marcus Andrew Redline, MPT
Individual provider Active NPI Physical Therapist · Wyalusing, PA
NPI 1609006733 · NPPES record last updated May 25, 2011
Key facts
- NPI
- 1609006733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT020046 (PA)
- Practice address
- 42 Complex Dr
Wyalusing, PA 18853-7803 - Phone
- (570) 746-0504
- Fax
- (570) 746-0470
- NPI assigned
- Jul 23, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Redline Rehab LLC
Practice addresses (Care Compare)
1110 W Main St
Troy, PA 16947-1172
Phone (570) 491-4900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110610000089 | PA | Practitioner - Physical Therapist in Private Practice | 0749467256 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redline Rehab, LLC | Current |
Accepting new patients | |
| Pivot Physical Therapy of Pennsylvania, LLC | Physical Therapist | Current |
Accepting new patients |
| Dynamic Therapy Services, LLC | Physical Therapist | Past | Accepting new patients |
Locations
824 McAlpine St
Ste 5
Avoca, PA 18641
Phone (570) 471-7662
328 Market St
Lewisburg, PA 17837
Phone (570) 768-4922
417 Grow Ave
Montrose, PA 18801
Phone (570) 278-1101
655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142
24569 Route 6
#C
Towanda, PA 18848
Phone (570) 265-1111
130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850
1110 W Main St
Troy, PA 16947
Phone (610) 739-8826
42 Complex Dr
Wyalusing, PA 18853
Phone (570) 746-0504
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT020046 | PA | Yes |
Addresses
Primary practice location
42 Complex Dr
Wyalusing, PA 18853-7803
Mailing address
24569 Route 6
Suite C
Towanda, PA 18848-8254
Phone (570) 265-1111
Other providers in Wyalusing, PA
- Millers Pharmacy Inc
- Leon A Mosher Jr.
- Olivia Noone
- Jeffrey Carl Pitcher
- Lucas Daniel Raymond
- Robert Ottaviani OD
- Sierra Schertler
- Alexandrea Steele
- Ali R Valentine
- Paul Richard Webb
All providers in Wyalusing, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.