NPIMap

Individual provider Active NPI

Marissa Stewart, PA-C

  • Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1033707542
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9115960 Issued in FL
Practice address
305 Memorial Medical Pkwy Ste 401
Daytona Beach, FL 32117-5169
Phone
(386) 231-3540
NPI assigned
Jan 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9115960 FL Primary

Addresses

Primary practice location

305 Memorial Medical Pkwy Ste 401
Daytona Beach, FL 32117-5169

Mailing address

305 Memorial Medical Pkwy Ste 401
Daytona Beach, FL 32117-5169
Phone (386) 231-3540

Other practice location 1

3437 Caroline St
Saint Louis, MO 63104-1111
Phone (314) 977-6338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220521000285 FL Practitioner - Physician Assistant 5991182420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

1200 Lexington Green LN
Sanford, FL 32771-1013

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9115960FLMDPhysician Assistant

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mstewart407049@adventhealth.direct-ci.com

Organizations & group practices 1

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1033707542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 401",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "386-231-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 401",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "386-231-3540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3437 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041111",
            "country_code": "US",
            "telephone_number": "314-977-6338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9115960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.