Individual provider Active NPI

Marissa Nichole Altmeyer, PA-C

  • Medical Physician Assistant
  • Waterford, PA
National Provider Identifier
1497427702
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA006297 Issued in PA
Practice address
991 Route 19 N Ste B
Waterford, PA 16441-9739
Phone
(814) 877-8790
Fax
(814) 877-8792
NPI assigned
Oct 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA062750 PA
Medical Physician Assistant 363AM0700X OA006297 PA Primary

Addresses

Primary practice location

991 Route 19 N Ste B
Waterford, PA 16441-9739

Mailing address

991 Route 19 N Ste B
Waterford, PA 16441-9739
Phone (814) 877-8790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20211220000296 PA Practitioner - Physician Assistant 3476944885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

991 Route 19 N B
Waterford, PA 16441-9739
Phone (814) 796-2553

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA062750PAMDMedical Physician Assistant
OA006297PAMDMedical Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1497427702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 ROUTE 19 N STE B",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164419739",
            "telephone_number": "814-877-8790",
            "fax_number": "814-877-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 ROUTE 19 N STE B",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164419739",
            "telephone_number": "814-877-8790",
            "fax_number": "814-877-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMEYER",
        "first_name": "MARISSA",
        "middle_name": "NICHOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA062750",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA006297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, PA

Sources for this page

Verify at the official NPI Registry.