Marissa Petchpradub

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

1144166604 Issued in NY

Practice address

550 1St Ave
New York, NY 10016-6402

Phone

(212) 263-5550

NPI assigned

Apr 27, 2026

Last updated

Oct 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1144166604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETCHPRADUB",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "1144166604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Pessolano, PA
• Caitlin Pestana Martins, MD
• Cecile Declaro Pestano, D.D.S.
• Kasia Petchel
• Claire Petchler, NP, PHD, RN
• Catherine Niyada Petchprapa, M.D.
• Matthew Petcoff, CNM
• Lisa Rae Pete, D.C.
• Morgan Petek, NP
• John Matthew Petela Jr., MD

• Emergency Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.