Marissa Bottos, FNP, APRN
Individual provider Active NPI Family Nurse Practitioner · La Porte, IN
NPI 1639720972 · NPPES record last updated Mar 19, 2026
Key facts
- NPI
- 1639720972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71009430A (IN)
- Practice address
- 1331 State St # 340
La Porte, IN 46350-3112 - Phone
- (219) 324-0875
- Fax
- (219) 324-0827
- NPI assigned
- Sep 27, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- La Porte Clinic Company LLC
Chesterton Physical Therapy Inc
Dalal Medical Corporation
Practice addresses (Care Compare)
1331 State St
Suite 340
La Porte, IN 46350-3112
Phone (219) 379-3166
425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589
9410 Calumet Ave
Munster, IN 46321-0018
Phone (219) 922-4900
Hospital & facility affiliations
- Methodist Hospitals Inc
- Northwest Health-la Porte
- Franciscan Health Munster
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.23 of 100
- Quality
- 84.45
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.64 of 100
- Quality
- 56.64
- Promoting interoperability
- 73
- Improvement activities
- 40
- Cost
- 76.72
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191114000477 | IN | Practitioner - Nurse Practitioner | 5698107555 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Methodist Hospitals, Inc | Current |
Accepting new patients | |
| La Porte Clinic Company LLC | Current |
Accepting new patients | |
| The Methodist Hospitals, Inc | Current |
Accepting new patients | |
| La Porte Clinic Company LLC | Current |
Accepting new patients | |
| Dalal Medical Corporation | Family | Current |
Accepting new patients |
Locations
27350 Network Pl
Chicago, IL 60673
2269 W 25th Ave
Gary, IN 46404
Phone (219) 738-2081
104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300
402 W Culver Rd
Knox, IN 46534
Phone (219) 772-7918
1331 State St
Ste 340
La Porte, IN 46350
Phone (219) 324-0875
401 Newport Blvd
Laporte, IN 46350
Phone (219) 326-1775
8777 Broadway
Merrillville, IN 46410
Phone (219) 736-5151
200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926
8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926
101 E 87th Ave
Merrillville, IN 46410
Phone (219) 738-6670
9410 Calumet Ave
Ste 401
Munster, IN 46321
Phone (219) 922-4900
Interoperability endpoints
- mbottos158173@direct.franciscanalliance.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71009430A | IN | Yes |
Addresses
Primary practice location
1331 State St # 340
La Porte, IN 46350-3112
Mailing address
1331 State St # 340
La Porte, IN 46350-3112
Phone (219) 324-0875
Other names
- Marissa Smith
Other providers in La Porte, IN
- Tracy Elizabeth Blanton
- Pamela Ann Boardman
- Janice Marie Bohlim
- Dawn L. Bohnert
- Michelle Boren
- Tiffany Bowen
- Stacy Lynn Brand-Lesley
- Carley Joy Brewster
- Brittany Brice
- Sarah Georgetta Jean Brinckman
All providers in La Porte, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.