Marissa Erin Backhaus, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

302 3Rd St SE
Loveland, CO 80537-6419

Phone

(970) 669-4855

NPI assigned

Sep 11, 2023

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

Other names 1

• Marissa McKeehan Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marissa.backhaus.1@27043.direct.athenahealth.com

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.

• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1902005382

  CO, Family Medicine

  Medicare reassignment Care Compare group NPD (past)
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Evans, CO
  • NPI 1295732048
  Care Compare group NPD
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Windsor, CO
  • NPI 1285372334
  Care Compare group
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Greeley, CO
  • NPI 1295041598
  Care Compare group
• Sunrise Community Health

  • Clinic Pharmacy
  • Loveland, CO
  • NPI 1609923283
  Care Compare group
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1700690252
  Care Compare group
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1750660726
  Care Compare group

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1699552109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 ARISTA PL APT 316",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800214177",
            "telephone_number": "920-562-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 3RD ST SE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805376419",
            "telephone_number": "970-669-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKHAUS",
        "first_name": "MARISSA",
        "middle_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "MCKEEHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Molly Avery, PT
• Awesome Smiles, P.C.
• Nathan Russell Ayer, M.D., M.P.H.
• Back on Track Physical Therapy
• Back to Health Chiropractic
• Brooke Badberg, LAC, MA
• Ruby Baggan, RD, IFNCP
• Alison Marie Bailey, MD
• Austin G Bailey Jr., M.D.
• Diana Lynn Bailey, FNP

• All providers in Loveland, CO
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.