Individual provider Active NPI

Marissa Ross, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1255913109
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2293349 Issued in MA
Practice address
1 Emerson PL Ste 3H
Boston, MA 02114-2252
Phone
(617) 397-3951
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 070155-23 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2293349 MA Primary

Addresses

Primary practice location

1 Emerson PL Ste 3H
Boston, MA 02114-2252

Mailing address

8 Fairview Cir
Groveland, MA 01834-1309
Phone (603) 860-6310

Other practice location 1

124 Watertown St Ste 2D
Watertown, MA 02472-2500
Phone (617) 916-5096

Other names 1

  • Marissa Hurley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230117002233 MA Practitioner - Nurse Practitioner 4486025129 Reassigns benefits to 1 organization
I20240328003021 NH Practitioner - Nurse Practitioner 4486025129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1 Emerson PL
Suite 3H
Boston, MA 02114-2252
Phone (855) 284-7483

173 S River Rd
Suite 2
Bedford, NH 03110-6930
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 5, 2023 Accepting new patients

Locations

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992

173 S River Rd
Ste 2
Bedford, NH 03110
Phone (603) 255-5267

3 Executive Park Dr
Ste 250
Bedford, NH 03110

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 1

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": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1255913109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FAIRVIEW CIR",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018341309",
            "telephone_number": "603-860-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMERSON PL STE 3H",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142252",
            "telephone_number": "617-397-3951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Watertown St Ste 2D",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "MA",
            "postal_code": "024722500",
            "country_code": "US",
            "telephone_number": "617-916-5096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MARISSA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "070155-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2293349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "HURLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.