NPIMap

Individual provider Active NPI

Marina Montserrat McKissack, PA-C

  • Physician Assistant
  • Rhinelander, WI
National Provider Identifier
1114957198
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1827-023 Issued in WI
Practice address
2251 North Shore Dr
Rhinelander, WI 54501
Phone
(715) 361-2000
NPI assigned
Jul 4, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 1827-023 WI Primary

Addresses

Primary practice location

2251 North Shore Dr
Rhinelander, WI 54501

Mailing address

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

Other names 1

  • Marina Montserrat Shepherdson-Santiago Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000632 WI Practitioner - Physician Assistant 4789636812 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians
Nova Integrated Care LLCGroup PAC ID 2860837291, 3 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

302 W Pine St
Suite 2
Eagle River, WI 54521-9349
Phone (715) 891-0088

9576 Hwy 70
Minocqua, WI 54548-9067
Phone (715) 358-1710

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

Merit-based Incentive Payment System (MIPS)

Final score
86.19 of 100Reported as group
Quality
74.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1827-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 4, 2018 Accepting new patients
Memorial Medical Center Inc CurrentSince Oct 15, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 4, 2018 Accepting new patients
Memorial Medical Center Inc CurrentSince Oct 15, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Jun 26, 2017 Accepting new patients
Racine Emergency Physicians, S.C. Past Accepting new patients

Locations

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: marina.mckissack@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 8

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1114957198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545016710",
            "telephone_number": "715-361-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 NORTH SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-361-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSACK",
        "first_name": "MARINA",
        "middle_name": "MONTSERRAT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1827-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2251 North Shore Dr",
            "city": "Rhinelander",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "SHEPHERDSON-SANTIAGO",
            "middle_name": "MONTSERRAT",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rhinelander, WI

Sources for this page

Verify at the official NPI Registry.