Individual provider Active NPI

Marissa Girolamo, D.P.M.

  • Foot Surgery Podiatrist
  • Stamford, CT
National Provider Identifier
1104813955
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
000558 Issued in CT
Practice address
1234 Summer St Ste 202
Stamford, CT 06905-5510
Phone
(203) 323-1711
Fax
(203) 323-4649
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 000558 CT Primary

Addresses

Primary practice location

1234 Summer St Ste 202
Stamford, CT 06905-5510

Mailing address

1234 Summer St Ste 202
Stamford, CT 06905-5510
Phone (203) 323-1171

Other identifiers 5

IdentifierTypeStateIssuer
480000468OtherCTMEDICARE ID#
022112OtherCTHEALTHNET
030000558CT01OtherCTBLUE CROSS
0328216002OtherCTCIGNA
95809OtherCTAETNA HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105001313 CT Practitioner - Podiatry 9830097104

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1234 Summer St
Suite 202
Stamford, CT 06905-5510

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions137
Removal of nail tissue505
Removal or shaving of skin growth207
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000558CTMDAddiction (Substance Use Disorder) Counselor

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1104813955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 SUMMER ST STE 202",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055510",
            "telephone_number": "203-323-1171",
            "fax_number": "203-323-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 SUMMER ST STE 202",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055510",
            "telephone_number": "203-323-1711",
            "fax_number": "203-323-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIROLAMO",
        "first_name": "MARISSA",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CT",
            "license": "000558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID#",
            "identifier": "480000468",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "022112",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "030000558CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0328216002",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH PLAN",
            "identifier": "95809",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.