Individual provider Active NPI

Breanne Amalia Marfisi, NP

  • Family Nurse Practitioner
  • Tomball, TX
National Provider Identifier
1407513872
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1073047 Issued in TX
Practice address
24727 Tomball Pkwy
Tomball, TX 77375-7877
Phone
(346) 336-7900
NPI assigned
Nov 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 892615 TX
Family Nurse Practitioner 363LF0000X 1073047 TX Primary

Addresses

Primary practice location

24727 Tomball Pkwy
Tomball, TX 77375-7877

Mailing address

24727 Tomball Pkwy
Tomball, TX 77375-7877

Other practice location 1

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231228000952 TX Practitioner - Nurse Practitioner 7315397643 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
892615TXMDRegistered Nurse
1073047TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David P Ellent PLLC CurrentSince Dec 1, 2023 Accepting new patients
Genesis Urgent Care LLC CurrentSince Jun 1, 2024 Accepting new patients
David P Ellent PLLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

108 N Main St
#A1
Dayton, TX 77535

22751 Professional Dr
Ste 140
Kingwood, TX 77339
Phone (281) 319-8380

9303 Pinecroft Dr
Ste 340
The Woodlands, TX 77380
Phone (281) 681-0616

26940 Kuykendahl Rd
Ste 200
Tomball, TX 77375
Phone (281) 357-5515

24727 State Highway 249
Ste 120
Tomball, TX 77375

26940 Kuykendahl Rd
Ste 100
Tomball, TX 77375

Interoperability endpoints

  • Direct secure messaging: breanne.marfisi.1@19704.direct.athenahealth.com

Organizations & group practices 3

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": "1637366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1407513872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24727 TOMBALL PKWY",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773757877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24727 TOMBALL PKWY",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773757877",
            "telephone_number": "346-336-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6411 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-704-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARFISI",
        "first_name": "BREANNE",
        "middle_name": "AMALIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-20",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "892615",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1073047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.