Individual provider Active NPI

Marissa Kate Poots, PA-C

  • Physician Assistant
  • Ankeny, IA
National Provider Identifier
1477185171
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3625 N Ankeny Blvd Ste F
Ankeny, IA 50023-4611
Phone
(515) 964-4600
Fax
(515) 965-5642
NPI assigned
Feb 10, 2020
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X IA Primary

Addresses

Primary practice location

3625 N Ankeny Blvd Ste F
Ankeny, IA 50023-4611

Mailing address

3156 SE Primrose Dr
Ankeny, IA 50021-7239
Phone (612) 719-8104

Other names 1

  • Marissa Kate Breider Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20211105000850 IA Practitioner - Physician Assistant 0648669085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center CurrentSince Dec 20, 2021 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jan 30, 2023 Accepting new patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Jan 30, 2023 Accepting new patients

Locations

3625 N Ankeny Blvd
Ste F
Ankeny, IA 50023
Phone (515) 964-4600

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1428 2nd Ave N
Fort Dodge, IA 50501
Phone (515) 573-1145

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

Interoperability endpoints

  • Direct secure messaging: mpoots851431@direct.unitypoint.org

Organizations & group practices 4

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 1

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1477185171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 SE PRIMROSE DR",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500217239",
            "telephone_number": "612-719-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 N ANKENY BLVD STE F",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234611",
            "telephone_number": "515-964-4600",
            "fax_number": "515-965-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOTS",
        "first_name": "MARISSA",
        "middle_name": "KATE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "BREIDER",
            "middle_name": "KATE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.