Individual provider Active NPI

Marisa Beals, MD

  • Obstetrics & Gynecology Physician
  • Trumbull, CT
National Provider Identifier
1356905319
Registry record updated Sep 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
77516 Issued in CT
Practice address
5520 Park Ave # WP2-700
Trumbull, CT 06611-3463
Phone
(203) 374-1018
Fax
(203) 396-0699
NPI assigned
Apr 25, 2019
Last updated
Sep 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 77516 CT Primary
Obstetrics & Gynecology Physician 207V00000X 25MA11776900 NJ

Addresses

Primary practice location

5520 Park Ave # WP2-700
Trumbull, CT 06611-3463

Mailing address

PO Box 22573
New York, NY 10087-2572
Phone (856) 669-6050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241101000651 CT Practitioner - Obstetrics/Gynecology 4789910639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
F H Netter, M.D. School of Med at Quinnipiac Univ, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women's Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

103 Newtown Rd
Candlewood Center for Womens Health
Danbury, CT 06810-4195
Phone (203) 730-8789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11776900NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women's Health LLC Obstetrics & Gynecology CurrentSince Nov 4, 2024 Accepting new patients
Northeast Medical Group, Inc. Obstetrics & Gynecology PastSince Oct 6, 2024 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

175 Capital Blvd
Fl 3
Rocky Hill, CT 06067

5520 Park Ave
#2700
Trumbull, CT 06611
Phone (203) 374-1018

5520 Park Ave
Ste M1700
Trumbull, CT 06611
Phone (203) 371-7177

5520 Park Ave
Ste WP2700
Trumbull, CT 06611
Phone (203) 374-1018

Interoperability endpoints

  • Direct secure messaging: marisa.beals.1@10170.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727568000000",
    "number": "1356905319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22573",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100872572",
            "telephone_number": "856-669-6050",
            "fax_number": "856-651-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE # WP2-700",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "203-374-1018",
            "fax_number": "203-396-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALS",
        "first_name": "MARISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "77516",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA11776900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.