Marissa Renee Bennett, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

OA002924 Issued in PA

Practice address

2652 Darlington Rd Ste 10
Beaver Falls, PA 15010-1295

Phone

(724) 891-3278

Fax

(724) 847-2785

NPI assigned

Dec 4, 2012

Last updated

Apr 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa Renee Defonde Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ucmg LLCGroup PAC ID 6709398969, 254 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Ucmg LLC

  • Urgent Care Clinic/Center
  • Allison Park, PA
  • NPI 1972300622
  Medicare reassignment Care Compare group NPD
• Urgent Care, PC - Pennsylvania

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1982839031
  Medicare reassignment
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - State College

  • Urgent Care Clinic/Center
  • State College, PA
  • NPI 1245556398
  NPD
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - St. Clair, Clover Dr

  • Urgent Care Clinic/Center
  • Saint Clair, PA
  • NPI 1720545320
  NPD
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - Brookhaven, Edgmont Ave

  • Urgent Care Clinic/Center
  • Brookhaven, PA
  • NPI 1437681335
  NPD (past)

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1063757979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2652 DARLINGTON RD STE 10",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101295",
            "telephone_number": "724-891-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2652 DARLINGTON RD STE 10",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101295",
            "telephone_number": "724-891-3278",
            "fax_number": "724-847-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARISSA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA002924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "DEFONDE",
            "middle_name": "RENEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beaver County MH Mr D&a Program (Beaver County Behavioral Health)
• Beaver County MH Mr Drug & Alcohol Program (Beaver County Behavioral Health)
• Beaver Falls Center for Nursing and Rehab, LLC (Beaver Falls Rehabilitation and Wellness Center)
• Beaver Valley Rehabilitation and Healthcare Center LLC
• Gina Belvedere, CRNP
• Brian Jason Betha, COTA/L
• Shreykumar Bhatt, MD
• Danielle Marie Bianco, O.D.
• Big Beaver Falls Area School District
• Laura Bingham

• Medical Physician Assistant in Beaver Falls, PA
• Providers in Beaver Falls, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.