Individual provider Active NPI

Marlene Walters, P.T., D.P.T.

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1689940215
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029355 Issued in NY
Practice address
2050 Prospect Ave
P10X
Bronx, NY 10457-3604
Phone
(718) 329-4678
Fax
(718) 364-5457
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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 029355 NY Primary

Addresses

Primary practice location

2050 Prospect Ave
P10X
Bronx, NY 10457-3604

Mailing address

2050 Prospect Ave
P10X
Bronx, NY 10457-3604
Phone (914) 434-4370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180226000567 NY Practitioner - Physical Therapist in Private Practice 6002177508 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mercy College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Caring PT Group PLLCGroup PAC ID 1355615956, 2 clinicians

Practice addresses (Care Compare)

17 N Plank Rd
Suite 10
Newburgh, NY 12550-2111
Phone (845) 800-9305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029355NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Caring PT Group, PLLC Physical Therapist CurrentSince Feb 12, 2018 Accepting new patients
Essential OT, PT, SLP & Psychology Services, PLLC CurrentSince Sep 1, 2020 Accepting new patients
Complete SLP, OT, PT & Psychology Services, PLLC CurrentSince Feb 16, 2021 Accepting new patients
Essential Therapy Services of NJ Physical Therapist PastSince Aug 1, 2021 Accepting new patients

Locations

17 N Plank Rd
Ste 10
Newburgh, NY 12550
Phone (845) 800-9305

Organizations & group practices 4

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1689940215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 PROSPECT AVE",
            "address_2": "P10X",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573604",
            "telephone_number": "914-434-4370",
            "fax_number": "718-364-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 PROSPECT AVE",
            "address_2": "P10X",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573604",
            "telephone_number": "718-329-4678",
            "fax_number": "718-364-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.