Individual provider Active NPI

Christie Nicole Marino, DPT

  • Physical Therapist
  • Valley Stream, NY
National Provider Identifier
1780355354
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047783 Issued in NY
Practice address
153 E Merrick Rd
Valley Stream, NY 11580-5925
Phone
(516) 400-9003
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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 047783 NY Primary

Addresses

Primary practice location

153 E Merrick Rd
Valley Stream, NY 11580-5925

Mailing address

2352 129TH St
College Point, NY 11356-2730
Phone (646) 708-6427

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211021000231 NY Practitioner - Physical Therapist in Private Practice 4385032523 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Doctor,P.C Physical Therapist CurrentSince Oct 1, 2021 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jun 1, 2023 Accepting new patients

Locations

21273 26th Ave
Bayside, NY 11360
Phone (718) 747-2019

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

Organizations & group practices 3

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1780355354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 129TH ST",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562730",
            "telephone_number": "646-708-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805925",
            "telephone_number": "516-400-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "CHRISTIE",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.