Individual provider Active NPI

Marcus B. Flexer, DPT

  • Physical Therapist
  • Mount Vernon, WA
National Provider Identifier
1780832170
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 60038308 Issued in WA
Practice address
1500 Continental PL
Mount Vernon, WA 98273-4105
Phone
(360) 424-7041
Fax
(360) 424-2456
NPI assigned
Aug 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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 PT 60038308 WA Primary

Addresses

Primary practice location

1500 Continental PL
Mount Vernon, WA 98273-4105

Mailing address

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-7041

Other practice location 1

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-7041

Other practice location 2

1017 20th St
Anacortes, WA 98221-2505
Phone (360) 424-7041

Other identifiers 2

IdentifierTypeStateIssuer
368391OtherWAWA LABOR & INDUSTRIES
1092790MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000295 WA Practitioner - Physical Therapist in Private Practice 4880752468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

190 W Dayton St
Suite 202
Edmonds, WA 98020-7221
Phone (425) 582-8118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 60038308WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Jan 11, 2020 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons, Inc., P.S CurrentSince Jan 11, 2020 Accepting new patients

Locations

1017 20th St
Anacortes, WA 98221
Phone (360) 424-7041

7320 216th St SW
Ste 320
Edmonds, WA 98026
Phone (425) 673-3900

190 W Dayton St
Ste 202
Edmonds, WA 98020
Phone (425) 252-4700

1500 Continental Pl
Mount Vernon, WA 98273
Phone (360) 424-7041

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1780832170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CONTINENTAL PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734105",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 S Laventure Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982746033",
            "country_code": "US",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1017 20th St",
            "address_purpose": "LOCATION",
            "city": "Anacortes",
            "state": "WA",
            "postal_code": "982212505",
            "country_code": "US",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEXER",
        "first_name": "MARCUS",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 60038308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "368391",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092790",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.