Individual provider Active NPI

Marisa Lynn Fisher, NP

  • Nurse Practitioner
  • Jamestown, NY
National Provider Identifier
1841900297
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
350856 Issued in NY
Practice address
207 Foote Ave
Jamestown, NY 14701-7077
Phone
(716) 483-0803
Fax
(716) 483-5144
NPI assigned
Nov 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 350856 NY Primary

Addresses

Primary practice location

207 Foote Ave
Jamestown, NY 14701-7077

Mailing address

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 483-0803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230120002401 NY Practitioner - Nurse Practitioner 7517338965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 483-5306

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
350856NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Area Medical Associates, L.L.P. CurrentSince Jun 1, 1997 Accepting new patients
Great Lakes Physician Practice PC CurrentSince Oct 13, 2022 Accepting new patients

Locations

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

Organizations & group practices 2

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 2

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": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1841900297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147017077",
            "telephone_number": "716-483-0803",
            "fax_number": "716-483-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147017077",
            "telephone_number": "716-483-0803",
            "fax_number": "716-483-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MARISA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "350856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.