NPIMap

Individual provider Active NPI

Marissa Elizabeth Shisler, FNP-C

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1760999692
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0993611-NP Issued in CO
Practice address
4020 Jerry Murphy Rd
Pueblo, CO 81001
Phone
(719) 546-3600
Fax
(719) 546-0931
NPI assigned
Dec 30, 2017
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0993611-NP CO Primary

Addresses

Primary practice location

4020 Jerry Murphy Rd
Pueblo, CO 81001

Mailing address

4020 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 546-3600

Other identifiers 2

IdentifierTypeStateIssuer
14612324OtherCOCAQH
9000163803MedicaidCO

Other names 1

  • Marissa Elizabeth Cassio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205000439 CO Practitioner - Nurse Practitioner 9638505928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Family Medicine Center, P.C.Group PAC ID 9739157827, 7 clinicians

Practice addresses (Care Compare)

4020 Jerry Murphy Rd
Pueblo, CO 81001-1045
Phone (719) 546-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Medicine Center, P.C. Family Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

4020 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 546-3600

Interoperability endpoints

  • Direct secure messaging: marissa.cassio.1@6060.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1514592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1760999692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 JERRY MURPHY RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81001",
            "telephone_number": "719-546-3600",
            "fax_number": "719-546-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 JERRY MURPHY RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81001",
            "telephone_number": "719-546-3600",
            "fax_number": "719-546-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHISLER",
        "first_name": "MARISSA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-30",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993611-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14612324",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000163803",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CASSIO",
            "middle_name": "ELIZABETH",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.