Marisa Jo Kooima, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN9246107 Issued in FL

Practice address

200 S Birch Rd Apt 1209
Ft Lauderdale, FL 33316-1537

Phone

(954) 629-2240

NPI assigned

Dec 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Marisa Kooima Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, NY2 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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lawnwood Cardiovascular Surgery LLCGroup PAC ID 7214937598, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228
• HCA Florida University Hospital Hospital, Davie, FL, CCN 100360

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: mkooima194699@direct.tgh.org

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.

• Lawnwood Cardiovascular Surgery LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Pierce, FL
  • NPI 1386724169
  Medicare reassignment Care Compare group NPD
• Duval Emergency Group LLC

  • Emergency Medicine Physician
  • North Miami Beach, FL
  • NPI 1053645465

  Nurse Practitioner

  Medicare reassignment NPD
• Wyckoff Professional Medical Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1659710796
  Medicare reassignment NPD
• Rebecca M Rivera Aprn LLC

  • Primary Care Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1578175360
  NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Thoracic & Cardiovascular Surgeons LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Atlantis, FL
  • NPI 1649212416
  NPD (past)

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

• Columbia Hospital Corporation of South Broward

  • General Acute Care Hospital
  • Plantation, FL
  • NPI 1063466589
  Care Compare affiliation
• Davie Medical Center, LLC

  • General Acute Care Hospital
  • Davie, FL
  • NPI 1871182956
  Care Compare affiliation

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1316240674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S BIRCH RD APT 1209",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161537",
            "telephone_number": "954-629-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S BIRCH RD APT 1209",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161537",
            "telephone_number": "954-629-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOIMA",
        "first_name": "MARISA",
        "middle_name": "JO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9246107",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9246107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "592202",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P988384",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  OF  FL",
            "identifier": "Y06HO",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P932403",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003103900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y06H0",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkooima194699@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "KOOIMA",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anna Kolodziejczyk
• Trevor Allen Kolski, PA-C
• Kathryn Kominars, PH.D.
• Inza Kone, PHARMD
• Megan Christine Kontol, MD
• Kope Executive Wellness and Psychotherapy
• Ashley Kopec, MD
• Megan Kopriva, NP
• William Korey, MD
• Barbara L Kornblau, JD, OTR, CCM, CDMS

• Nurse Practitioner in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.

Verify at the official NPI Registry.