NPIMap

Individual provider Active NPI

Marissa Andrice Baty, P.A.

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1619941382
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004079 Issued in MI
Practice address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone
(616) 840-8000
Fax
(616) 840-9642
NPI assigned
Feb 17, 2006
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 5601004079 MI Primary

Addresses

Primary practice location

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Mailing address

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-8000

Other names 1

  • Marissa Andrice Barnes Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbaty138589@direct.covenanthealthcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070925000420 MI Practitioner - Physician Assistant 4082708797 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihp Mi Emergency Medicine PLLCGroup PAC ID 2365821634, 42 clinicians
Inhospital Physicians Michigan PLLCGroup PAC ID 5991208407, 19 clinicians

Practice addresses (Care Compare)

1213 Mason St
Dearborn, MI 48124-2841
Phone (313) 278-2800

2601 Electric Ave
Port Huron, MI 48060-6587
Phone (810) 216-1500

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004079MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan PLLC CurrentSince Mar 1, 2020 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Dec 1, 2024 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince Nov 1, 2022 Accepting new patients
Ihp Mi Emergency Medicine PLLC CurrentSince Oct 1, 2025 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Dec 1, 2024 Accepting new patients
Pine Rest Christian Mental Health Services Physician Assistant Past Accepting new patients
Pine Rest Christian Mental Health Services Past Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients
Grand Rapids Addiction Medicine Specialists PC Past Accepting new patients
Hospitalists of West Michigan PC Past Accepting new patients

Locations

1213 Mason St
Dearborn, MI 48124
Phone (313) 278-2800

1213 Mason St
Ste 3
Dearborn, MI 48124

13403 W 7 Mile Rd
Ste A
Detroit, MI 48235
Phone (313) 308-2444

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

6245 Inkster Rd
Garden City, MI 48135
Phone (734) 421-3300

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

2601 Electric Ave
Port Huron, MI 48060
Phone (810) 216-1500

610 Sentry Pkwy
Bldg 660
Blue Bell, PA 19422

Interoperability endpoints

  • Direct secure messaging: mbaty138589@direct.covenanthealthcare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1619941382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8000",
            "fax_number": "616-840-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8000",
            "fax_number": "616-840-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATY",
        "first_name": "MARISSA",
        "middle_name": "ANDRICE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbaty138589@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "235 Wealthy St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495035247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "BARNES",
            "middle_name": "ANDRICE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.