Individual provider Active NPI

Marisa Lois, MD

  • Emergency Medicine Physician
  • Ponce, PR
National Provider Identifier
1487141396
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T3508 Issued in TX
Practice address
917 Ave Tito Castro
Ponce, PR 00716-4717
Phone
(787) 844-2080
Fax
(787) 841-7165
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2021-0720 NM
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X T3508 TX Primary

Addresses

Primary practice location

917 Ave Tito Castro
Ponce, PR 00716-4717

Mailing address

11441 Lakeside Dr Apt 2310
Doral, FL 33178-3041
Phone (310) 863-4719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210928000473 TX Practitioner - Emergency Medicine 9335546787 Reassigns benefits to 1 organization
I20211005000922 NM Practitioner - Emergency Medicine 9335546787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northeastern Ohio University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services of Texas PAGroup PAC ID 7517289291, 57 clinicians

Practice addresses (Care Compare)

10301 Gateway Blvd W
Del Sol Med Ctr
El Paso, TX 79925-7701
Phone (915) 595-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T3508TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Emergency Medical Associates of NM PC Emergency Medicine CurrentSince Aug 5, 2021 Accepting new patients
Emergency Services of Texas PA Emergency Medicine CurrentSince Sep 17, 2021 Accepting new patients

Locations

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

1535 N Resler Dr
El Paso, TX 79912
Phone (915) 231-1600

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

10301 Gateway Blvd W
El Paso, TX 79925
Phone (915) 543-2424

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 and National Provider Directory roles.

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": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1487141396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11441 LAKESIDE DR APT 2310",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331783041",
            "telephone_number": "310-863-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 AVE TITO CASTRO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164717",
            "telephone_number": "787-844-2080",
            "fax_number": "787-841-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOIS",
        "first_name": "MARISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2021-0720",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T3508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.