VIVIAN MARMOLEJO (PT) – Physical Therapist, NPI 1215988407

VIVIAN MARMOLEJO (PT) is a healthcare provider. based in Pembroke pines, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT19590 (FL). The NPI Number for VIVIAN MARMOLEJO (PT) is 1215988407

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
VIVIAN MARMOLEJO (PT)
NPI
1215988407
Phone
(954) 443-2420
Address
1561 N PALM AVE
Enumeration Date
13 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9544432420
Graduation Year
1995 (31 years ago)
PAC ID
3971975343
Group Practice PAC ID
8820261092
Professional Enrollment ID
I20230213000200
Address ID
FL330242209HO7900XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

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Provider Addresses for VIVIAN MARMOLEJO (PT)

  • 1561, North Palm Avenue, Pembroke Pines, Broward County, Florida, 33026, United States

    PEMBROKE PINES, FL 330263229

    Phone: (954) 443-2420

    Fax: (954) 443-8422

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-02-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230213000200IPhysical Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33026)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820261092View full group profile
NameSpecialtyState
C H I R O P R A C T I CFL
C H I R O P R A C T I CNY

Reviews

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Frequently asked questions

Can I verify VIVIAN MARMOLEJO (PT) with an NPI only?
You can start verification with NPI 1215988407 for VIVIAN MARMOLEJO (PT), then check state licensing separately.
Is VIVIAN MARMOLEJO (PT) listed as active for patients and plans?
The listing shows VIVIAN MARMOLEJO (PT) as active in the NPI system.
What is VIVIAN MARMOLEJO (PT)'s primary classification?
Physical Therapist is the headline specialty for VIVIAN MARMOLEJO (PT) here. Clinical services aligned with this taxonomy classification.
What area does VIVIAN MARMOLEJO (PT) serve?
VIVIAN MARMOLEJO (PT)'s listing highlights Pembroke Pines, Florida; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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