MARLESA MARIA JOHNSON DPT
NPI 1235781345
Physical Therapist in Paw Paw, MI
NPI Status: Active since July 10, 2019
- Individual
- Female
- Years of Experience 10
- Physical Therapist
- Accepts Insurance
- Accepts Medicare Approved Payment
About MARLESA JOHNSON
This page provides the complete NPI Profile along with additional information for Marlesa Johnson, a provider established in Paw Paw, Michigan with a medical specialization in Physical Therapist and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1235781345 assigned on July 2019. The practitioner's primary taxonomy code is 225100000X. The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1235781345
- Provider Name
- MARLESA MARIA JOHNSON DPT
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 451 HEALTH PKWY PAW PAW, MI 49079
- Location Phone
- (269) 657-1490
- Mailing Address
- 38208 M 40 PAW PAW, MI 49079
- Medical School Name
- OTHER
- Graduation Year
- 2016
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-10-2019
- Last Update Date
- 07-17-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Therapist
- Taxonomy Code
- 225100000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Taxonomy Description
- Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Bronson Healthcare Partners - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Enhanced Gold Bronson Healthcare Partners - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Bronson Healthcare Partners - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (No Referrals) - HMO
- UHC Bronze Value+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage (No Referrals) - HMO
- UHC Silver Advantage+ (Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Marlesa Johnson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
PECOS PAC ID: 8820467756
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20221215000400
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.18 for a new patient copayment and $17.01 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 49079 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.74
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.68
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.67
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.07
- Minimum Established Patient Price $17.09
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $17.01
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 3 | 5 | 7 | 8 | 1 | 3 | 4 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 6 | 5 | 14 | 8 | 2 | 3 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 6 + 5 + 1 + 4 + 8 + 2 + 3 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1235781345 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1972585115 | VINCENT R CABRAS MD Individual | Family Medicine | 451 HEALTH PKWY SUITE B PAW PAW, MI 49079 (269) 655-3065 |
| 1073525358 | PIOTR JAN MIETUSIEWICZ PHYSICAL THERAPIST Individual | Physical Therapist | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 657-8300 |
| 1467464768 | RYAN E. LANGEJANS PHYSICAL THERAPIST Individual | Physical Therapist | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-1720 |
| 1679676217 | MR. RONALD L PERRY R.PH Individual | Pharmacist | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-3095 |
| 1811048101 | MR. GREGORY ROBERT HUGHES PA-C Individual | Physician Assistant (Medical) | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-1715 |
| 1639370430 | BRONSON OUTPATIENT PHARMACY-PAW PAW Organization | Pharmacy (Community/Retail Pharmacy) | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-3095 |
| 1932477320 | MR. BRUCE ALLEN WALL JR. PT, DPT Individual | Physical Therapist | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 657-1490 |
| 1033115183 | PAMELA NELSON M.D. Individual | Family Medicine | 451 HEALTH PKWY SUITE B PAW PAW, MI 49079 (269) 655-3065 |
| 1861492423 | LYNNE MARIE LOUNSBURY CNP Individual | Nurse Practitioner | 451 HEALTH PKWY SUITE B PAW PAW, MI 49079 (269) 655-3065 |
| 1609858844 | JOHN W KAVANAUGH JR. MD Individual | Pediatrics | 451 HEALTH PKWY SUITE E PAW PAW, MI 49079 (269) 655-3090 |
| 1417937020 | ROSE M ROTH-BOWERSOCK PNP-BC Individual | Nurse Practitioner (Pediatrics) | 451 HEALTH PKWY SUITE E PAW PAW, MI 49079 (269) 655-3090 |
| 1235195298 | MR. GERALD M BUSH P.A.-C Individual | Physician Assistant | 451 HEALTH PKWY SUITE B PAW PAW, MI 49079 (269) 655-3065 |
| 1558644674 | MS. JAMIE LYNN CHILES ANP Individual | Nurse Practitioner (Primary Care) | 451 HEALTH PKWY SUITE F PAW PAW, MI 49079 (269) 655-3080 |
| 1467858118 | SARA BAILEY FNP-BC Individual | Nurse Practitioner | 451 HEALTH PKWY SUITE A PAW PAW, MI 49079 (269) 657-2550 |
| 1720439979 | KIMBERLY BAKER LMSW Individual | Social Worker (Clinical) | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-3067 |
| 1053729269 | DR. TODD SUPER PHARM.D., BCPS Individual | Pharmacist (Ambulatory Care) | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-1735 |
| 1336709500 | MR. DANIEL E LAIRD PT, DPT Individual | Physical Therapist (Orthopedic) | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 657-1490 |
| 1962701664 | PEACHIE SMITH PT Individual | Physical Therapist | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 657-1490 |
| 1114570801 | KINJU DUDHIA PT Individual | Physical Therapist | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 657-1490 |
| 1972132256 | JEAN MARIE BROSNAN RN Individual | Registered Nurse (Ambulatory Care) | 451 HEALTH PKWY PAW PAW, MI 49079 (269) 655-1729 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235781345, enumerated in the NPI registry as an "individual" on July 10, 2019
The provider is located at 451 Health Pkwy Paw Paw, Mi 49079 and the phone number is (269) 657-1490
The provider's speciality is Physical Therapist with taxonomy code 225100000X
The provider has more than 10 years of experience.
The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Blue Care. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Medicare beneficiaries should expect a typical cost of $84.74 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $68.07 and an average copayment of 17.01. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on July 10, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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