Active NPI
Marissa Fischer, PA-C
- Physician Assistant
- Kalkaska, MI
National Provider Identifier
1194299693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601008962
- Practice address
- 419 S Coral St
Kalkaska, MI 49646-2503 - Phone
- (231) 258-7500
- NPI assigned
- Jan 17, 2019
- Last updated
- Nov 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Physician Assistant | 363A00000X | 5601008962 | MI | Primary |
Addresses
Primary practice location
419 S Coral St
Kalkaska, MI 49646-2503
Mailing address
PO Box 916
Traverse City, MI 49685-0916
Phone (231) 258-7506
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5315203825 | Other | MI | PHARMACY (CS-2) |
| 5601008962 | Other | MI | LICENSE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MFISCHER2@direct.mhc.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- 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, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601008962 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalkaska Memorial Health Center | Multi-Specialty | Current | Accepting new patients |
| Kalkaska Memorial Health Center | Current | Accepting new patients | |
| Kalkaska Memorial Health Center | Multi-Specialty | Current | Accepting new patients |
| Kalkaska Memorial Health Center | Multi-Specialty | Past | Accepting new patients |
Locations
419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500
Interoperability endpoints
- mfischer2@direct.mhc.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Kalkaska, MI
- NPI 1013183060
Multi-Specialty
-
- Skilled Nursing Facility
- Kalkaska, MI
- NPI 1164386652
-
- Family Medicine Physician
- Kalkaska, MI
- NPI 1376799650
Multi-Specialty
-
- Rural Health Clinic/Center
- Kalkaska, MI
- NPI 1306968102
Multi-Specialty
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Kalkaska, MI
- NPI 1497751309
-
- General Acute Care Hospital
- Traverse City, MI
- NPI 1952307852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669334400000",
"number": "1194299693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 916",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496850916",
"telephone_number": "231-258-7506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 S CORAL ST",
"city": "KALKASKA",
"state": "MI",
"postal_code": "496462503",
"telephone_number": "231-258-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCHER",
"first_name": "MARISSA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-17",
"last_updated": "2022-11-25",
"certification_date": "2022-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601008962",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY (CS-2)",
"identifier": "5315203825",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "5601008962",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MFISCHER2@direct.mhc.net",
"affiliation": "N",
"address_1": "419 S Coral St",
"city": "Kalkaska",
"state": "MI",
"country_code": "US",
"postal_code": "496462503",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kalkaska, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; 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.