Individual provider Active NPI

Marisa N Barber, PA-C

  • Physician Assistant
  • Arroyo Grande, CA
National Provider Identifier
1083048169
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA23039 Issued in CA
Practice address
860 Oak Park Blvd
Ste 101
Arroyo Grande, CA 93420-1800
Phone
(805) 481-3685
Fax
(805) 481-5245
NPI assigned
Aug 26, 2013
Last updated
Aug 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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 PA23039 CA Primary

Addresses

Primary practice location

860 Oak Park Blvd
Ste 101
Arroyo Grande, CA 93420-1800

Mailing address

860 Oak Park Blvd
Ste 101
Arroyo Grande, CA 93420-1800
Phone (805) 481-3685

Other names 1

  • Marisa Nicole Landes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20140131001022 CA Practitioner - Physician Assistant 5991934531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
64.37
Promoting interoperability
100
Improvement activities
40
Cost
72.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA23039CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Urgent Care #3, Inc. CurrentSince May 2, 2016 Accepting new patients
First Choice Physician Partners CurrentSince Jun 1, 2022 Accepting new patients
First Choice Physician Partners CurrentSince Jun 1, 2022 Accepting new patients
Arroyo Grande Surgical Institute, LLC PastSince Jul 17, 2022 Accepting new patients

Locations

2415 E Imperial Hwy
Brea, CA 92821
Phone (714) 255-1640

78965 Highway 111
Ste 100
La Quinta, CA 92253
Phone (706) 777-7847

2010 E Carson St
Long Beach, CA 90807
Phone (213) 401-0371

115 Eastpark Dr
Ste 300
Brentwood, TN 37027

Interoperability endpoints

  • Direct secure messaging: marisa.barber@729355633164292.direct.elationemr.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1083048169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OAK PARK BLVD",
            "address_2": "STE 101",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201800",
            "telephone_number": "805-481-3685",
            "fax_number": "805-481-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 OAK PARK BLVD",
            "address_2": "STE 101",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201800",
            "telephone_number": "805-481-3685",
            "fax_number": "805-481-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBER",
        "first_name": "MARISA",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA23039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "LANDES",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.