Individual provider Active NPI

Marissa Yvette Tagle, PA-C

  • Physician Assistant
  • McAllen, TX
National Provider Identifier
1174899330
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07755 Issued in TX
Practice address
2215 W Fern Ave Ste B
McAllen, TX 78501-6177
Phone
(956) 540-5181
Fax
(956) 468-2079
NPI assigned
Mar 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 PA07755 TX Primary

Addresses

Primary practice location

2215 W Fern Ave Ste B
McAllen, TX 78501-6177

Mailing address

2215 W Fern Ave Ste B
McAllen, TX 78501-6177
Phone (956) 540-5181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120605000761 TX Practitioner - Physician Assistant 6608030531 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Functional Health PLLCGroup PAC ID 6002221207, 2 clinicians

Practice addresses (Care Compare)

2215 W Fern Ave
Suiteb
McAllen, TX 78501-6176
Phone (956) 476-3686

Merit-based Incentive Payment System (MIPS)

Final score
77.39 of 100Reported as group
Quality
68.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54916CAMDDentist
PA07755TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients
Doctors Hospital at Renaissance, LTD PastSince Apr 1, 2023 Accepting new patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1174899330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 W FERN AVE STE B",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016177",
            "telephone_number": "956-540-5181",
            "fax_number": "956-468-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 W FERN AVE STE B",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016177",
            "telephone_number": "956-540-5181",
            "fax_number": "956-468-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGLE",
        "first_name": "MARISSA",
        "middle_name": "YVETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-31",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.