Marisa Renee Altamirano, PA-C

Key facts

NPI: 1679247233
Entity type: Individual (NPI type 1)
Primary specialty: Surgical Physician Assistant 363AS0400X
License: 25MP00637000 (NJ)
Practice address: 113 W Essex St
Maywood, NJ 07607-1023
Phone: (201) 289-5551
NPI assigned: Aug 5, 2021
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

The Plastic Surgery Center Plastic and Reconstructive Surgery Physician · Red Bank, NJ · NPI 1386613834

Medicare reassignment Care Compare group NJ
University Medical Professionals LLC Critical Care Medicine (Internal Medicine) Physician · Elizabeth, NJ · NPI 1346304664

Medicare reassignment NJ
Morris Avenue Medical Center PC Cardiovascular Disease Physician · Union, NJ · NPI 1134369200

NPD (past)
The Woods O.R., Inc. Ambulatory Surgical Clinic/Center · Tinton Falls, NJ · NPI 1952610768

NPD (past)

Medicare Care Compare profile

Specialty: Physician Assistant
Education: Other, 2021
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: The Plastic Surgery Center (88 clinicians)

Practice addresses (Care Compare)

377 Jersey Ave
Suite 220
Jersey City, NJ 07302-4396
Phone (732) 333-8720

535 Sycamore Ave
Shrewsbury, NJ 07702-4224
Phone (732) 333-8720

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NJ
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
I20210928000781	NJ	Practitioner - Physician Assistant	5991102352	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
The Woods O.R., Inc.		Past since May 18, 2025	Accepting new patients
Morris Avenue Medical Center PC		Past since Aug 28, 2021	Accepting new patients

Interoperability endpoints

Direct secure messaging: maltamirano864044@ahs.direct-ci.com
FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10045835

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Surgical Physician Assistant	363AS0400X	25MP00637000	NJ	Yes

Addresses

Primary practice location

113 W Essex St
Maywood, NJ 07607-1023

Mailing address

113 W Essex St
Maywood, NJ 07607-1023
Phone (201) 289-5551

Other providers in Maywood, NJ

All providers in Maywood, NJ · Surgical Physician Assistant in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2024. 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.

Verify at the official NPI Registry.