Marissa Decesaris, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP017981 Issued in PA

Practice address

3300 Henry Ave
Philadelphia, PA 19129-1121

Phone

(215) 254-2069

NPI assigned

Oct 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Elwyn of Pennsylvania and Delaware

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1972643203
  NPD (past)

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427569706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S 17TH ST APT 201N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461939",
            "telephone_number": "609-230-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 HENRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291121",
            "telephone_number": "215-254-2069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Elwyn Rd",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190634622",
            "country_code": "US",
            "telephone_number": "610-891-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Market St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191043003",
            "country_code": "US",
            "telephone_number": "215-895-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECESARIS",
        "first_name": "MARISSA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP017981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Decastro, AC-PNP
• Michele Jean Decastro, CRNP
• Sarah Beth Decedue
• Gloria Decena
• Mary Angela Decena, CRNP
• Sarah B Dechamplain
• Tenzin Dechen
• Lori Deck
• Gabrielle Decker-O'Gara
• Charlie David Decker

• Psychiatric/Mental Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.