Marissa Martina Breeze

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

25 Prospect Ave
Hackensack, NJ 07601-1960

Phone

(201) 343-2277

NPI assigned

Sep 5, 2018

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 NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Active Orthopedics and Sports Medicine, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Hackensack, NJ
  • NPI 1922389600
  Medicare reassignment NPD

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550966400000",
    "number": "1740762889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011960",
            "telephone_number": "201-343-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEZE",
        "first_name": "MARISSA",
        "middle_name": "MARTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2019-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Bray, APN
• Devin Marie Himchak Braz, PA-C
• Breath and Lung Institute, LLC
• Kathi Brechner
• Christine Noel Breen, PA-C
• Sydney Breitkopf, DPT
• Keith Brenner, M.D.
• Samantha K. Brenner, M.D., M.P.H.
• Eric Robert Bresemann, PT
• Nancy Brey, MSN, CNS.C

• Surgical Physician Assistant in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.