Individual provider Active NPI

Marissa Rose Zito, PA-C

  • Physician Assistant
  • Stroudsburg, PA
National Provider Identifier
1083452957
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA065755 Issued in PA
Practice address
100 St Lukes LN
Stroudsburg, PA 18360-6217
Phone
(484) 526-6643
NPI assigned
Jul 16, 2024
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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 MA065755 PA Primary

Addresses

Primary practice location

100 St Lukes LN
Stroudsburg, PA 18360-6217

Mailing address

100 St Lukes LN
Stroudsburg, PA 18360-6217
Phone (484) 526-6643

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240729001811 PA Practitioner - Physician Assistant 0345786182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

100 St Lukes LN
Stroudsburg, PA 18360-6217
Phone (484) 526-2200

100 St Lukes Way
Stroudsburg, PA 18360-6217
Phone (272) 212-1000

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065755PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Aug 26, 2024 Accepting new patients
St Luke's Physician Group Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

100 St Lukes Ln
Stroudsburg, PA 18360
Phone (272) 212-1000

Interoperability endpoints

  • Direct secure messaging: mzito244619@direct-sluhn.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1083452957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ST LUKES LN",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606217",
            "telephone_number": "484-526-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST LUKES LN",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606217",
            "telephone_number": "484-526-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITO",
        "first_name": "MARISSA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.