Marissa G Charles, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M7101 Issued in TX

Practice address

6157 NW Loop 410
Ste. 124
San Antonio, TX 78238-3302

Phone

(210) 523-1411

Fax

(210) 523-9307

NPI assigned

Dec 15, 2008

Last updated

Oct 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Marissa E Garza Former name

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Family Practice

Education

University of North Texas HSC, College of Osteopathic Med, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marissa.charles@wellmed.eclinicaldirectplus.com

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.

• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Wellmed Medical Group, P.a.

  dba WellMed Doctor's Hospital Senior Clinic

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD
• Wellmed Medical Group, P.a.

  dba WellMed at Telshor

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1659679157
  NPD

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1568607984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6157 NW LOOP 410",
            "address_2": "STE. 124",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383302",
            "telephone_number": "210-523-1411",
            "fax_number": "210-523-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6157 NW LOOP 410",
            "address_2": "STE. 124",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383302",
            "telephone_number": "210-523-1411",
            "fax_number": "210-523-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MARISSA",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M7101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "1994998-04",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "386468YLPS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "GARZA",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles S. Ramon, LLC. (La Estrella Home Care)
• Charles T Gay MD PA
• Charles Thomas MD PA
• Diana C Charles
• Julie Charles, RN
• Michon Rica Charles, LPC
• Rachel Style Charles
• Shamika Charles
• Stephanie Nicole Charles, RN
• Tyrone Samuel Charles Jr., MA, LPC, LCDC

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.