Individual provider Active NPI

Marissa Ferrazzo-Weller, D.O.

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1780943001
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
264928 Issued in NY
Practice address
6 Brighton Rd FL 2
Clifton, NJ 07012-1647
Phone
(973) 777-7911
Fax
(973) 777-5403
NPI assigned
May 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 264928 NY Primary

Addresses

Primary practice location

6 Brighton Rd FL 2
Clifton, NJ 07012-1647

Mailing address

275 N. Middletown Rd. Suite 1F
Pearl River, NY 10965
Phone (845) 920-1990

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713001717 NJ Practitioner - Internal Medicine 2567619463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

  • Valley Home Care Inc. Home health agency, Paramus, NJ, CCN 317008
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
  • St Mary'S General Hospital Hospital, Passaic, NJ, CCN 310006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
264928NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jul 18, 2016 Accepting new patients
Summit Medical Group PA CurrentSince Jul 18, 2016 Accepting new patients
New Jersey Physicians LLC Internal Medicine Past Accepting new patients
Summit Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

1255 Broad St
Clifton, NJ 07013
Phone (973) 471-0981

Interoperability endpoints

  • Direct secure messaging: marissa.ferrazzoweller.1@2983.direct.athenahealth.com

Organizations & group practices 4

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 5

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": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1780943001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 N. MIDDLETOWN RD. SUITE 1F",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "10965",
            "telephone_number": "845-920-1990",
            "fax_number": "845-920-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BRIGHTON RD FL 2",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121647",
            "telephone_number": "973-777-7911",
            "fax_number": "973-777-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRAZZO-WELLER",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-07",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "264928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.