Individual provider Active NPI

Marissa Pittius, PA-C

  • Physician Assistant
  • Camden, NJ
National Provider Identifier
1528638558
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00631000 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 546-8525
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00631000 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

95 Bridge Plaza Dr
Manalapan, NJ 07726-1700
Phone (732) 851-5546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240812002278 NJ Practitioner - Physician Assistant 4587102397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2339 Route 70 W
FL 3
Cherry Hill, NJ 08002-3315
Phone (856) 795-3597

3 Cooper PLZ
Camden, NJ 08103-1438

3 Cooper PLZ
RM 104
Camden, NJ 08103-1407
Phone (856) 968-7965

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00631000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA CurrentSince Jul 30, 2024 Accepting new patients

Locations

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

1 Federal St
Ste 200
Camden, NJ 08103
Phone (848) 288-6935

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

2339 Route 70 W
Fl 2
Cherry Hill, NJ 08002
Phone (856) 532-9519

2339 Route 70 W
Cherry Hill, NJ 08002
Phone (856) 406-4080

1450 Almonesson Rd
Ste H
Deptford, NJ 08096
Phone (848) 288-6935

309 Bridgeboro Rd
Moorestown, NJ 08057
Phone (856) 439-2000

Interoperability endpoints

  • Direct secure messaging: mpittius185025@direct.cooperhealth.edu

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 3

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1528638558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-546-8525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Bridge Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Manalapan",
            "state": "NJ",
            "postal_code": "077261700",
            "country_code": "US",
            "telephone_number": "732-851-5546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITTIUS",
        "first_name": "MARISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00631000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.