Marissa Renee De Leon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10429 Issued in TX

Practice address

2106 Hale Ave
Harlingen, TX 78550-8408

Phone

(956) 423-9111

NPI assigned

Mar 23, 2016

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Juan a Maldonado MD PA

  • Family Medicine Physician
  • Harlingen, TX
  • NPI 1902880487
  Medicare reassignment

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1194187682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 HALE AVE",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508408",
            "telephone_number": "956-423-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 HALE AVE",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508408",
            "telephone_number": "956-423-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "MARISSA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA10429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luis De la Torre Jr., MD
• Laurie De Leon - Escobedo, FNP-C
• Iris Ann Soto De Leon, PHYSICAL THERAPIST
• Janet Miranda De Leon
• Luis Antonio De Leon, LVN
• Miriam Daniela De Leon, PA-C
• Ramon De Leon, D.D.S.
• Raul De Leon Jr., LCDC
• Sergio De Leon
• Victor Hugo De Leon Jr.

• Medical Physician Assistant in Harlingen, TX
• Providers in Harlingen, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; 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.