Individual provider Active NPI

Marissa Rose Ortiz, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1760102453
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116564 Issued in FL
Practice address
10150 Highland Manor Dr Ste 205
Tampa, FL 33610-9727
Phone
(813) 259-1013
Fax
(813) 254-0396
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9116564 FL Primary

Addresses

Primary practice location

10150 Highland Manor Dr Ste 205
Tampa, FL 33610-9727

Mailing address

10150 Highland Manor Dr Ste 205
Tampa, FL 33610-9727
Phone (813) 259-1013

Other identifiers 1

IdentifierTypeStateIssuer
115719700MedicaidFL

Other names 1

  • Marissa Rahn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20221003001880 FL Practitioner - Physician Assistant 6103202940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluestone Physician Services Southeast LLCGroup PAC ID 9739086257, 25 clinicians

Practice addresses (Care Compare)

10150 Highland Manor Dr
Suite 205
Tampa, FL 33610-9727
Phone (813) 259-1013

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Venice, FL, CCN 107522
  • Discovery at Home LLC Home health agency, Fort Myers, FL, CCN 109783
  • Trilogy Home Healthcare Home health agency, Sarasota, FL, CCN 109371
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Amedisys Home Health Home health agency, Port Charlotte, FL, CCN 108270
  • Sunnyside Nursing Home Nursing home, Sarasota, FL, CCN 106053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bluestone Physician Services Southeast LLC CurrentSince Sep 3, 2024 Accepting new patients
My Home Doctor, LLC Past Accepting new patients

Locations

10150 Highland Manor Dr
Ste 205
Tampa, FL 33610
Phone (813) 259-1013

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1760102453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR STE 205",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109727",
            "telephone_number": "813-259-1013",
            "fax_number": "813-254-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR STE 205",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109727",
            "telephone_number": "813-259-1013",
            "fax_number": "813-254-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "MARISSA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115719700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "RAHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.