Individual provider Active NPI

Marcus Hieb, PT

  • Physical Therapist
  • Bismarck, ND
National Provider Identifier
1790709673
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1551 Issued in ND
Practice address
1000 Tacoma Ave
Sutie 500
Bismarck, ND 58504-7036
Phone
(701) 751-3001
Fax
(701) 751-3089
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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 1551 ND Primary

Addresses

Primary practice location

1000 Tacoma Ave
Sutie 500
Bismarck, ND 58504-7036

Mailing address

1000 Tacoma Ave
Sutie 500
Bismarck, ND 58504-7036
Phone (701) 751-3001

Other identifiers 1

IdentifierTypeStateIssuer
55714MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110122000066 ND Practitioner - Physical Therapist in Private Practice 9335265735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Therapy and Fitness, LLCGroup PAC ID 0547386948, 6 clinicians

Practice addresses (Care Compare)

1000 Tacoma Ave
Suite 500
Bismarck, ND 58504-7093
Phone (701) 751-3001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1551NDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy and Fitness, LLC Physical Therapist CurrentSince Jul 1, 2010 Accepting new patients

Locations

3231 Greensboro Dr
Ste 102
Bismarck, ND 58503
Phone (701) 354-1200

1000 Tacoma Ave
Ste 500
Bismarck, ND 58504
Phone (701) 751-3001

Organizations & group practices 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1790709673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TACOMA AVE",
            "address_2": "SUTIE 500",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585047036",
            "telephone_number": "701-751-3001",
            "fax_number": "701-751-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TACOMA AVE",
            "address_2": "SUTIE 500",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585047036",
            "telephone_number": "701-751-3001",
            "fax_number": "701-751-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIEB",
        "first_name": "MARCUS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55714",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.