Marisa Rose Doll, PA-C

Individual provider Active NPI Physician Assistant · Yaphank, NY

NPI 1831865534 · NPPES record last updated Feb 10, 2025

Key facts

NPI
1831865534
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
5585 (SC)
Practice address
527 Boulevard E
Yaphank, NY 11980-7512
Phone
(631) 504-0427
NPI assigned
Aug 22, 2021
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Urgent Care of South Carolina PC (158 clinicians)

Practice addresses (Care Compare)

1305 S Suber Rd
Greer, SC 29650-0944
Phone (864) 989-4609

3025 Wade Hampton Blvd
Taylors, SC 29687-2715
Phone (864) 643-2340

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100 (apm)
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY, SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210928001199 NY Practitioner - Physician Assistant 7719384189 Reassigns benefits to 2 organizations
I20250310003645 SC Practitioner - Physician Assistant 7719384189 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mdoll831857@direct.ghs.myhfn.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 027122 NY
Physician Assistant 363A00000X 5585 SC Yes

Addresses

Primary practice location

527 Boulevard E
Yaphank, NY 11980-7512

Mailing address

101 Hospital Rd
Patchogue, NY 11772-4870
Phone (631) 745-2857

Other practice location 1

101 Hospital Rd
Patchogue, NY 11772-4870
Phone (631) 654-7100

Other practice location 2

905 Verdae Blvd Ste 101
Greenville, SC 29607-4098
Phone (864) 990-1910

Other names

  • Marisa Balbo Former name

Other providers in Yaphank, NY

All providers in Yaphank, NY · Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.