NPIMap

Individual provider Active NPI

Marissa Page, NP

  • Family Nurse Practitioner
  • Latham, NY
National Provider Identifier
1659691491
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336183 Issued in NY
Practice address
6 Wellness Way Ste 113
Latham, NY 12110-2142
Phone
(518) 782-3899
Fax
(518) 782-3884
NPI assigned
Jun 3, 2010
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336183 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste 113
Latham, NY 12110-2142

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
03273750MedicaidNY

Other names 1

  • Marissa Kanthal Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120125000222 NY Practitioner - Nurse Practitioner 1951578368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3277

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
98.76
Improvement activities
40
Cost
76.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336183NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Nov 24, 2011 Accepting new patients
Albany Medical College Past Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

6 Wellness Way
Ste 106
Latham, NY 12110
Phone (518) 237-7363

6 Wellness Way
Ste 113
Latham, NY 12110
Phone (518) 782-3899

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 104
Latham, NY 12110
Phone (518) 782-3813

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

2388 Route 9
Ste 103
Mechanicville, NY 12118
Phone (518) 264-4055

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1659691491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 113",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102142",
            "telephone_number": "518-782-3899",
            "fax_number": "518-782-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "MARISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03273750",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "KANTHAL",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.