Individual provider Active NPI

Marissa Rae Matarrese, MD

  • Plastic Surgery Physician
  • Plattsburgh, NY
National Provider Identifier
1891816740
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
268664-1 Issued in NY
Practice address
214 Cornelia St
#103
Plattsburgh, NY 12901-2306
Phone
(518) 562-7771
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 268664-1 NY Primary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 268664 NY

Addresses

Primary practice location

214 Cornelia St
#103
Plattsburgh, NY 12901-2306

Mailing address

60 Club Rd
#304
Plattsburgh, NY 12903-4919
Phone (585) 746-0413

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000475 NY Practitioner - Plastic and Reconstructive Surgery 9133362262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Washington School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

206 Cornelia St
Plattsburgh, NY 12901-2779

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7100

77 Plaza Blvd
Plattsburgh, NY 12901-6438

91 Plaza Blvd
Plattsburgh, NY 12901-6438
Phone (518) 561-5334

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as apm
Quality
71.44
Promoting interoperability
97.95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268664-1NYMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center CurrentSince Jul 1, 2013 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

214 Cornelia St
Ste 103
Plattsburgh, NY 12901
Phone (518) 314-3070

Interoperability endpoints

  • Direct secure messaging: mmatarrese182668@direct.uvmhealth.org

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 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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1891816740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CLUB RD",
            "address_2": "#304",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129034919",
            "telephone_number": "585-746-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CORNELIA ST",
            "address_2": "#103",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012306",
            "telephone_number": "518-562-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATARRESE",
        "first_name": "MARISSA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "268664-1",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "268664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.