Marissa Lynn Saengsamran, APRN, BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2001015646 Issued in MO

Practice address

816 S Kirkwood Rd Ste 210
Saint Louis, MO 63122-6056

Phone

(314) 645-4500

Fax

(314) 645-5907

NPI assigned

Dec 27, 2006

Last updated

Dec 30, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1891179040
  Medicare reassignment Care Compare group NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • O'Fallon, MO
  • NPI 1689039836
  NPD
• St. Louis Dermatology and Surgery Center, PC

  • MOHS-Micrographic Surgery Physician
  • Saint Louis, MO
  • NPI 1659304061
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1609931963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 S KIRKWOOD RD STE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226056",
            "telephone_number": "314-645-4500",
            "fax_number": "314-645-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAENGSAMRAN",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "credential": "APRN,  BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2001015646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Marissa.Saengsamran@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "816 S Kirkwood Rd Ste 210",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631226056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fatima Saeed, MBBS
• Nabeela Saeed, M.D.
• Mehrdad Saeedvafa, MD
• Saman Saeidi, DPT
• Bhudsadee Saenghirunvattana, DDS
• Jose Bernardo Saenz, MD
• Angela Kay Saettele, MD
• Tonia Saettele, PHARMD
• Rawan Ahmad Safa, MD
• Catherine A Safari

• Gerontology Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.