NPIMap

Individual provider Active NPI

Marisa N Wallas, DO

  • Family Medicine Physician
  • Cranberry Township, PA
National Provider Identifier
1033748199
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS022818 Issued in PA
Practice address
20630 Route 19
Cranberry Township, PA 16066-6021
Phone
(724) 779-2273
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS022818 PA Primary

Addresses

Primary practice location

20630 Route 19
Cranberry Township, PA 16066-6021

Mailing address

600 Grant St FL 58
Pittsburgh, PA 15219-2739

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marisa.n.wallas@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230821003530 PA Practitioner - Family Practice 6608238720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upmc Community Medicine IncGroup PAC ID 2062318975, 736 clinicians

Practice addresses (Care Compare)

20630 Route 19
Unit 101
Cranberry TWP, PA 16066-6021
Phone (724) 779-2273

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Butler, PA, CCN 398146
  • Upmc Passavant Hospital, Pittsburgh, PA, CCN 390107
  • Magee Womens Hospital of Upmc Health System Hospital, Pittsburgh, PA, CCN 390114

Merit-based Incentive Payment System (MIPS)

Final score
83.75 of 100Reported as group
Quality
70.53
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS022818PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Upmc Community Medicine, Inc Current Accepting new patients
Upmc Community Medicine Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Upmc Community Medicine Inc Family Medicine Past Accepting new patients

Locations

20630 Route 19
Unit 101
Cranberry Twp, PA 16066
Phone (724) 779-2273

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

Organizations & group practices 4

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 5

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1033748199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRANT ST FL 58",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152192739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20630 ROUTE 19",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160666021",
            "telephone_number": "724-779-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLAS",
        "first_name": "MARISA",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS022818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marisa.n.wallas@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cranberry Township, PA

Sources for this page

Verify at the official NPI Registry.