Individual provider Active NPI

Marissa Faith Wyatt, CRNA

  • Certified Registered Nurse Anesthetist
  • Sebastian, FL
National Provider Identifier
1073076931
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11014736 Issued in FL
Practice address
13695 US Highway 1
Sebastian, FL 32958-3230
Phone
(772) 589-3196
Fax
(321) 843-2196
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 883594 TX
Certified Registered Nurse Anesthetist 367500000X 120273 AR
Certified Registered Nurse Anesthetist 367500000X APRN11014736 FL Primary

Addresses

Primary practice location

13695 US Highway 1
Sebastian, FL 32958-3230

Mailing address

13695 US Highway 1
Sebastian, FL 32958-3230
Phone (772) 589-3196

Other practice location 1

13695 US Highway 1
Sebastian, FL 32958-3230
Phone (772) 589-3186

Other practice location 2

1910 Malvern Ave
Hot Springs, AR 71901
Phone (501) 321-1000

Other identifiers 1

IdentifierTypeStateIssuer
117204000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, FL, TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190702002487 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183958689 Reassigns benefits to 1 organization
I20220722003068 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183958689 Reassigns benefits to 5 organizations
I20230630002913 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183958689

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (722) 589-3186

Hospital & facility affiliations

  • Orlando Health Sebastian River Hospital Hospital, Sebastian, FL, CCN 100217

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
883594TXMDRegistered Nurse
120273ARMDCertified Registered Nurse Anesthetist
APRN11014736FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Live Oak Endoscopy Center, LLC CurrentSince Oct 16, 2024 Accepting new patients
Ouachita Regional Anesthesia PLLC CurrentSince Jul 1, 2019 Accepting new patients
Vero Anesthesia CurrentSince Apr 6, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2025 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 18, 2023 Accepting new patients
Steward Anesthesiology Physicians of Florida Inc. CurrentSince Apr 21, 2022 Accepting new patients

Locations

1910 Malvern Ave
Hot Springs National Park, AR 71901
Phone (501) 321-1000

8820 Knoedl Ct
Little Rock, AR 72205
Phone (501) 224-6767

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

275 18th St
Ste 101
Vero Beach, FL 32960
Phone (772) 299-5005

1325 36th St
Ste B
Vero Beach, FL 32960
Phone (772) 589-0331

Organizations & group practices 7

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 1

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1073076931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13695 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583230",
            "telephone_number": "772-589-3196",
            "fax_number": "321-843-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13695 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583230",
            "telephone_number": "772-589-3196",
            "fax_number": "321-843-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13695 US Highway 1",
            "address_purpose": "LOCATION",
            "city": "Sebastian",
            "state": "FL",
            "postal_code": "329583230",
            "country_code": "US",
            "telephone_number": "772-589-3186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 Malvern Ave",
            "address_purpose": "LOCATION",
            "city": "Hot Springs",
            "state": "AR",
            "postal_code": "71901",
            "country_code": "US",
            "telephone_number": "501-321-1000",
            "fax_number": "501-620-2336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "MARISSA",
        "middle_name": "FAITH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "883594",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "120273",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11014736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117204000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.