NPIMap

Individual provider Active NPI

Marissa Louise Kummerling, MD, MPH

  • Family Medicine Physician
  • Eureka, CA
National Provider Identifier
1467897942
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A149373 Issued in CA
Practice address
2200 Tydd St
Eureka, CA 95501-1284
Phone
(707) 441-1624
Fax
(707) 441-1253
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A149373 CA Primary

Addresses

Primary practice location

2200 Tydd St
Eureka, CA 95501-1284

Mailing address

670 9TH St Ste 203
Arcata, CA 95521-6249
Phone (707) 826-8633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171030001881 CA Practitioner - Family Practice 9032439260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2200 Tydd St
Eureka, CA 95501-1284
Phone (707) 441-1624

2350 Buhne St
Suite a
Eureka, CA 95501-3205
Phone (707) 443-4593

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149373CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Shasta Diablo Inc Current Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Planned Parenthood Shasta Diablo Inc CurrentSince May 11, 2024 Accepting new patients
Open Door Community Health Centers CurrentSince Sep 18, 2017 Accepting new patients
Planned Parenthood Shasta Diablo Inc CurrentSince May 11, 2024 Accepting new patients
Open Door Community Health Centers CurrentSince Sep 18, 2017 Accepting new patients
HCA Healthone LLC Past Accepting new patients
Mad River Community Anesthesia Medical Group Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Open Door Community Health Centers Past Accepting new patients
Planned Parenthood: Shasta-Diablo, Inc. Past Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

3800 Janes Rd
#101
Arcata, CA 95521
Phone (707) 822-1385

1275 8th St
Arcata, CA 95521

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

3100 Cohasset Rd
Chico, CA 95973
Phone (530) 342-2949

2185 Pacheco St
Concord, CA 94520
Phone (925) 676-0300

2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051

670 9th St
Ste 203
McKinleyville, CA 95521

Interoperability endpoints

  • Direct secure messaging: mkummerling312525@direct.ochin.org
  • Direct secure messaging: marissa.kummerlingmd.p1@direct.ppnorcal.nextgenshare.com
  • Direct secure messaging: mkummerling216361@direct.ochin.org

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467897942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST STE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216249",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 TYDD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011284",
            "telephone_number": "707-441-1624",
            "fax_number": "707-441-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMMERLING",
        "first_name": "MARISSA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A149373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.