Individual provider Active NPI

Marissa Grace Leli

  • Physician Assistant
  • Naples, FL
National Provider Identifier
1114782000
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118485 Issued in FL
Practice address
6376 Pine Ridge Rd Unit 180
Naples, FL 34119-3926
Phone
(239) 263-0849
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 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 PA9118485 FL Primary

Addresses

Primary practice location

6376 Pine Ridge Rd Unit 180
Naples, FL 34119-3926

Mailing address

10620 Founders Way Unit 307
Bonita Springs, FL 34135-5624
Phone (239) 220-4804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240315002277 FL Practitioner - Physician Assistant 8820434566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naples Heart Rhythm Specialists PAGroup PAC ID 8729177035, 21 clinicians

Practice addresses (Care Compare)

6376 Pine Ridge Rd
Naples, FL 34119-3926
Phone (239) 263-0849

730 Goodlette Rd N
Suite 100
Naples, FL 34102-5617
Phone (239) 682-6603

Hospital & facility affiliations

  • Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: marissa.leli.1@25641.direct.athenahealth.com

Organizations & group practices 1

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 2

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1114782000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 FOUNDERS WAY UNIT 307",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341355624",
            "telephone_number": "239-220-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6376 PINE RIDGE RD UNIT 180",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193926",
            "telephone_number": "239-263-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELI",
        "first_name": "MARISSA",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.