Marisa Mccormack, is a medicare enrolled "Physical Therapist" provider in Shalimar, Florida. She graduated from medical school in 2020 and has 6 years of diverse experience with area of expertise as Physical Therapist In Private Practice. She is a member of the group practice Pro Vita Physical Therapy Llc and her current practice location is
4 8th St Unit A, Shalimar, Florida. You can reach out to her office (for appointments etc.) via phone at
(330) 554-0631.
Marisa Mccormack is licensed to practice in Florida (license number PT35820) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1730705518.
Healthcare Provider's Profile
| Full Name | Marisa Mccormack |
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| Gender | Female |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 6 Years |
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| Location | 4 8th St Unit A, Shalimar, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Marisa Mccormack graduated from medical school in 2020
NPI Data:
- NPI Number: 1730705518
- Provider Enumeration Date: 06/17/2020
- Last Update Date: 01/23/2026
Medicare PECOS Information:
- PECOS PAC ID: 7416326764
- Enrollment ID: I20240315001612
Medical Identifiers
Medical identifiers for Marisa Mccormack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1730705518 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | PT302271 (California) | Secondary |
| 225100000X | Physical Therapist | PT35820 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Pro Vita Physical Therapy Llc | 6901226976 | 9 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Marisa Mccormack allows following entities to bill medicare on her behalf.
| Provider Name | Pro Vita Physical Therapy Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1790332351
PECOS PAC ID: 6901226976
Enrollment ID: O20201013000689 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marisa Mccormack is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Marisa Mccormack,
4 8th St Unit A,
Shalimar, FL 32579-2146
Ph: (330) 554-0631 | Marisa Mccormack,
4 8th St Unit A,
Shalimar, FL 32579-2146
Ph: (330) 554-0631 |
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