NPIMap

Individual provider Active NPI

Marissa Ann Spencer, PA

  • Physician Assistant
  • Mankato, MN
National Provider Identifier
1598314916
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1025 Marsh St
Mankato, MN 56001
Phone
(507) 625-4031
NPI assigned
Sep 9, 2019
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001

Mailing address

11150 Executive Acres Rd
Brainerd, MN 56401-5929
Phone (218) 316-4185

Other practice location 1

1025 Marsh St
Mankato, MN 56001
Phone (507) 625-4031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191021000032 MN Practitioner - Physician Assistant 5890026058 Reassigns benefits to 1 organization
I20260329000044 SD Practitioner - Physician Assistant 5890026058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Nov 7, 2019 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

Interoperability endpoints

  • Direct secure messaging: mspencer655271@ehrdirect.mayoclinicmsg.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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1598314916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 EXECUTIVE ACRES RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564015929",
            "telephone_number": "218-316-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Marsh St",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "56001",
            "country_code": "US",
            "telephone_number": "507-625-4031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.