Active NPI
Marshle Fontilus, DPT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1740836865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 451 Clarkson Ave Ste C1117
Brooklyn, NY 11203-2054 - Phone
- (718) 245-7148
- NPI assigned
- Aug 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
451 Clarkson Ave Ste C1117
Brooklyn, NY 11203-2054
Mailing address
451 Clarkson Ave Ste C1117
Brooklyn, NY 11203-2054
Phone (718) 245-7148
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Marshle.fontilus@nychhc.org | Direct | Kings County Hospital |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028021 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Physical Therapy Services PC | Single Specialty | Current | Accepting new patients |
| Homeside Rehab, PT, OT, SLP LLC | Single Specialty | Current | Accepting new patients |
Locations
2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600
441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436
296 Route 59
Ste 1225
Suffern, NY 10901
Interoperability endpoints
- marshle.fontilus@nychhc.org
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Monsey, NY
- NPI 1023258431
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1740836865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 CLARKSON AVE STE C1117",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032054",
"telephone_number": "718-245-7148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 CLARKSON AVE STE C1117",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032054",
"telephone_number": "718-245-7148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTILUS",
"first_name": "MARSHLE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-14",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Marshle.fontilus@nychhc.org",
"affiliation": "Y",
"endpointDescription": "email address",
"affiliationName": "Kings County Hospital",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "451 Clarkson Ave",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112032057",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.