Marisa Mendel, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

258996 Issued in MA

Practice address

199 Wells Ave Ste 102
Newton Centre, MA 02459-3320

Phone

(781) 472-1477

Fax

(412) 753-7640

NPI assigned

Mar 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmendel158270@direct.upstate.edu
• Direct secure messaging: mendelm@hiemail.healtheconnections.org

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.

• Psychiatry Faculty Practice, Inc.

  • Psychiatry Physician
  • Syracuse, NY
  • NPI 1881084820
  Medicare reassignment NPD
• Marisa Mendel MD PLLC

  • Child & Adolescent Psychiatry Physician
  • Newton Centre, MA
  • NPI 1548862162
  NPD Authorized official

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1184913154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 WELLS AVE STE 102",
            "city": "NEWTON CENTRE",
            "state": "MA",
            "postal_code": "024593320",
            "telephone_number": "781-472-1477",
            "fax_number": "412-753-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 WELLS AVE STE 102",
            "city": "NEWTON CENTRE",
            "state": "MA",
            "postal_code": "024593320",
            "telephone_number": "781-472-1477",
            "fax_number": "412-753-7640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102695",
            "country_code": "US",
            "telephone_number": "315-464-3265",
            "fax_number": "315-464-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEL",
        "first_name": "MARISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "330764",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "258996",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "330764",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "258996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott McCarthy, NP-C
• Aila Jesse McCutchen, PSYD
• Merrill Fowler Mead-Fox, PH.D.
• Jenna Mehlhorn
• Joyce Mendel, M.D.
• Mighty Mouths, LLC
• Colleen Mills, MA, LMHC
• Kiran L. Milunsky, LICSW
• Mind'S Eye Therapy, LLC
• Renee Anne Moran, DO

• Child & Adolescent Psychiatry Physician in Newton Centre, MA
• Providers in Newton Centre, MA by specialty
• Child & Adolescent Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.