Marissa L Stankus, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

171 Grandview Ave Ste 201
Waterbury, CT 06708-2520

Phone

(203) 578-4630

Fax

(203) 578-4629

NPI assigned

Sep 16, 2008

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

Medicare fee-for-service enrollment

Enrolled in CT

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Naugatuck Valley Ear, Nose and Throat Associates, LLCGroup PAC ID 7012045107, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment Care Compare group
• Naugatuck Valley Ear, Nose and Throat Associates, LLC

  • Otolaryngology Physician
  • Waterbury, CT
  • NPI 1326362799
  Medicare reassignment Care Compare group
• CT Colony Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Waterbury, CT
  • NPI 1831444322
  NPD (past)
• Waterbury Hospital

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1184615114
  NPD (past)

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

• Saint Mary'S Hospital, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1760426969
  Care Compare affiliation

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1700035615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE STE 201",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082520",
            "telephone_number": "203-578-4630",
            "fax_number": "203-578-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE STE 201",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082520",
            "telephone_number": "203-578-4630",
            "fax_number": "203-578-4629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_2": "Department of Otolaryngology 2L",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANKUS",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Mary'S Hospital
• St. Vincent Depaul Mission of Waterbury, Inc.
• Amy Marie Stack, LPC
• Stallworth Counseling Services,LLC
• Marcus Allen Stallworth, LMSW
• Joseph Stanley
• Sarah E. Starbird, LCSW
• Tracy Starbird, LPC
• State Dental
• State of Connecticut

• Physician Assistant in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.