Active NPI
Marissa Mitter
- Physician Assistant
- Lexington, SC
National Provider Identifier
1124731419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MPA.4708
- Practice address
- PO Box 487
Lexington, SC 29071-0487 - Phone
- (803) 699-9073
- Fax
- (866) 527-0937
- NPI assigned
- Jan 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MPA.4708 | SC | Primary |
Addresses
Primary practice location
PO Box 487
Lexington, SC 29071-0487
Mailing address
PO Box 487
Lexington, SC 29071-0487
Phone (803) 699-9073
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
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
Practice addresses (Care Compare)
101 N Hermitage Rd
Beaufort, SC 29902-5321
Phone 8036999073170
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4708 | SC | MD | Physical Therapist |
| MPA.4708 | SC | MD | Physician Assistant |
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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Beaufort, SC
- NPI 1023155728
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1124731419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 487",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290710487",
"telephone_number": "803-699-9073",
"fax_number": "866-527-0937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 487",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290710487",
"telephone_number": "803-699-9073",
"fax_number": "866-527-0937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITTER",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-02",
"last_updated": "2025-07-21",
"certification_date": "2025-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "MPA.4708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.