Individual provider Active NPI

Marisa Joy Wiswell, ACNP

  • Acute Care Nurse Practitioner
  • Washington, DC
National Provider Identifier
1265020101
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN1043748 Issued in DC
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 715-4000
NPI assigned
Jan 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN1043748 DC Primary

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 715-4000

Other practice location 1

110 Irving St NW Ste 4B49
Washington, DC 20010-3017
Phone (202) 877-5190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20210609003132 DC Practitioner - Nurse Practitioner 6901206127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 715-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1043748DCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Center Corp Current Accepting new patients
Washington Hospital Center Corp CurrentSince Mar 6, 2021 Accepting new patients
Washington Hospital Center Corp CurrentSince Mar 6, 2021 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Jul 24, 2023 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

110 Irving St NW
Ste 4B49
Washington, DC 20010
Phone (202) 877-5190

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1265020101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW Ste 4B49",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-5190",
            "fax_number": "202-877-3173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISWELL",
        "first_name": "MARISA",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2023-07-27",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "RN1043748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.