Individual provider Active NPI

Marissa Cardell, PA-C

  • Physician Assistant
  • Enfield, CT
National Provider Identifier
1194387431
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
155 Hazard Ave Ste 2
Enfield, CT 06082-4586
Phone
(860) 698-6041
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 Primary

Addresses

Primary practice location

155 Hazard Ave Ste 2
Enfield, CT 06082-4586

Mailing address

628 Spring St
Manchester, CT 06040-6746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MW Wellness VIII, LLC CurrentSince Jan 12, 2025 Accepting new patients
MW Wellness II, LLC PastSince Jan 12, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Past Accepting new patients

Locations

155 Hazard Ave
Ste 2
Enfield, CT 06082
Phone (860) 698-6041

Organizations & group practices 3

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1194387431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 SPRING ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HAZARD AVE STE 2",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824586",
            "telephone_number": "860-698-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDELL",
        "first_name": "MARISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.