Active NPI
Marissa Masters
- Physical Therapy Assistant
- Mesa, AZ
National Provider Identifier
1760016042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA-014045
- Practice address
- 3850 E Baseline Rd Ste 109
Mesa, AZ 85206-4403 - Phone
- (480) 818-4212
- NPI assigned
- Feb 26, 2020
- 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 Therapy Assistant | 225200000X | PTA-014045 | AZ | Primary |
Addresses
Primary practice location
3850 E Baseline Rd Ste 109
Mesa, AZ 85206-4403
Mailing address
8621 E Northland Dr
Scottsdale, AZ 85251-1856
Phone (480) 639-8869
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-014045 | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1760016042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8621 E NORTHLAND DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852511856",
"telephone_number": "480-639-8869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3850 E BASELINE RD STE 109",
"city": "MESA",
"state": "AZ",
"postal_code": "852064403",
"telephone_number": "480-818-4212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTERS",
"first_name": "MARISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-26",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "PTA-014045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.