Marissa Nicole Perkins, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10004304A Issued in IN

Practice address

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160

Phone

(260) 435-7001

NPI assigned

Dec 20, 2023

Last updated

Aug 21, 2025By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21210/brand/1/csg/1/fhir/r4
• Direct secure messaging: marissa.perkins.1@21210.direct.athenahealth.com

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.

• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment
• Inphynet Primary Care Physicians Midwest, S.C.

  • Physician Assistant
  • Fort Wayne, IN
  • NPI 1528090610
  Medicare reassignment
• Fertility and Midwifery Care Center LLC

  • Obstetrics & Gynecology Physician
  • Fort Wayne, IN
  • NPI 1376955070
  NPD (past)

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1326817222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 COLUMBIA AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054310",
            "telephone_number": "260-388-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044160",
            "telephone_number": "260-435-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 6354004",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452634160",
            "country_code": "US",
            "telephone_number": "888-952-6772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 DuBois Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803210",
            "country_code": "US",
            "telephone_number": "574-267-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468023697",
            "country_code": "US",
            "telephone_number": "856-686-4341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "MARISSA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004304A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071483",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine N Periolat
• Abhilash Perisetti, M.D
• Chakqwuona Perkins Rush
• Elizabeth L Perkins, PT, DPT
• Genna Marianna Perkins, NP
• Chase Permann, DO
• Jennifer Perry, MS
• Kelly Marie Perry, FNP
• Nancy Anne Perry, LPN
• Jane Ann Persing

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.