Marlena Pelliccio, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15405 Issued in MA

Practice address

425 Centre St
Newton, MA 02458-2063

Phone

(617) 244-1990

Fax

(617) 244-1811

NPI assigned

Jan 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Marathon Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Newton, MA
  • NPI 1346373115
  NPD (past)

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801947262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027662436",
            "telephone_number": "508-285-5533",
            "fax_number": "508-285-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582063",
            "telephone_number": "617-244-1990",
            "fax_number": "617-244-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICCIO",
        "first_name": "MARLENA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "11491578",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "Y68475",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Weight Management Centers LLC (Great Moves)
• Pediatrics at Newton Wellesley, PC
• Pedodontic Associates of Newton, Inc.
• Mallory Celine Peishoff
• Alexa Belle Pellenberg
• Allison Pendleton
• Teron Peoples
• Peoplesdental, P.C. (Newton Centre Dental)
• Kiana Peralta
• Kimberly D Percival, LICSW

• Physical Therapist in Newton, MA
• Providers in Newton, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.