NPIMap

Individual provider Active NPI

Marissa B Anderson-Chernishof, M.D., M.S.

  • Internal Medicine Physician
  • Silverdale, WA
National Provider Identifier
1235549957
Registry record updated May 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61188611 Issued in WA
Practice address
1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone
(360) 744-8800
NPI assigned
May 2, 2014
Last updated
May 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61188611 WA Primary

Addresses

Primary practice location

1800 NW Myhre Rd
Silverdale, WA 98383-7663

Mailing address

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (642) 403-1075

Other practice location 1

939 Caroline St
Port Angeles, WA 98362-3909
Phone (360) 565-9237

Other identifiers 1

IdentifierTypeStateIssuer
2182680MedicaidWA

Other names 1

  • Marissa B Chernishof Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210818003994 WA Practitioner - Internal MedicinePractitioner - Hospitalist 7315342052 Reassigns benefits to 2 organizations
I20240418003548 NE Practitioner - Internal Medicine 7315342052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10452 Silverdale Way NW
Silverdale, WA 98383-9411
Phone (360) 307-7300

2520 Cherry Ave
Bremerton, WA 98310-4229
Phone (360) 377-3911

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 12, 2024 Accepting new patients
Faith Regional Physician Services, LLC Internal Medicine CurrentSince Apr 11, 2024 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Apr 11, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 12, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Aug 6, 2021 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Aug 6, 2021 Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Commonspirit Washington Community Care Past Accepting new patients

Locations

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: manderson4373513@ghc.direct-ci.net
  • Direct secure messaging: manderson473107@direct.nebraskamed.com

Organizations & group practices 10

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715472000000",
    "number": "1235549957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837663",
            "telephone_number": "642-403-1075",
            "fax_number": "564-240-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837663",
            "telephone_number": "360-744-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Port Angeles",
            "state": "WA",
            "postal_code": "983623909",
            "country_code": "US",
            "telephone_number": "360-565-9237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON-CHERNISHOF",
        "first_name": "MARISSA",
        "middle_name": "B",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2024-05-12",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61188611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2182680",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1800 NW Myhre Rd",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983837663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CHERNISHOF",
            "middle_name": "B",
            "credential": "M.D., M.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.