Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Marissa Bacon, PT, DPT

Individual provider Physical Therapist · NPI 1073068722

MS. Marissa Bacon, PT, DPT is a Physical Therapist in Private Practice in Kenosha, Wisconsin. Qualified in 2016, 10 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
10
Licensed in
WI
In the registry since
2016
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

10400 75th St
Kenosha, WI 53142-7884
Phone: (262) 948-3600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 13544-24 (WI)

Record details

NPI number1073068722
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedAugust 23, 2016
Last updated in NPPESNovember 19, 2021
Certification dateNovember 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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