Individual provider Active NPI

Michelle Marroquin, PTA

  • Physical Therapy Assistant
  • Northampton, MA
National Provider Identifier
1750163192
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9226 Issued in MA
Practice address
39 Carlon Dr
Northampton, MA 01060-2392
Phone
(413) 727-3315
Fax
(413) 727-3316
NPI assigned
Oct 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 9226 MA Primary

Addresses

Primary practice location

39 Carlon Dr
Northampton, MA 01060-2392

Mailing address

17 Dragon Cir
Easthampton, MA 01027-1301
Phone (413) 210-2594

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9226MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1750163192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DRAGON CIR",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010271301",
            "telephone_number": "413-210-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CARLON DR",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602392",
            "telephone_number": "413-727-3315",
            "fax_number": "413-727-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARROQUIN",
        "first_name": "MICHELLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "9226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.