Marisa Pilar Roddy, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

4197 Issued in NM

Practice address

5006 Copper Ave NE
Albuquerque, NM 87108-1301

Phone

(505) 268-7988

Fax

(505) 268-8021

NPI assigned

Sep 17, 2012

Last updated

Mar 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Luz Therapy ServicesGroup PAC ID 0749612943, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• La Luz Therapy Services

  • Physical Therapy Clinic/Center
  • Albuquerque, NM
  • NPI 1104366533

  Pediatrics

  Medicare reassignment Care Compare group NPD Authorized official
• Explorabilities Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Albuquerque, NM
  • NPI 1346210473
  NPD (past)

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1972853026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 COPPER AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081301",
            "telephone_number": "505-328-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 COPPER AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081301",
            "telephone_number": "505-268-7988",
            "fax_number": "505-268-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "MARISA",
        "middle_name": "PILAR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NM",
            "license": "4197",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NM",
            "license": "4197",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10171568",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY MEDICARE",
            "identifier": "326556",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Damien Rodarte
• Daniella Rodarte, LMT
• Dominique Patrice Rodarte
• Michele Rodarte
• Anthony R Roddy, PT, DPT
• Kelly Rode
• Martha Rode
• Richard Rode
• August Rodefeld
• Amanda N Rodela, PA-C

• Pediatric Physical Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pediatric Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.