Marissa B Bothun, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07230 Issued in TX

Practice address

1020 W Ralph Hall Pkwy Ste 102
Rockwall, TX 75032-8711

Phone

(972) 390-9002

Fax

(972) 722-3553

NPI assigned

Feb 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa B Bothun Other name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matthew D Barrows MD PAGroup PAC ID 6305894171, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

76.77 of 100Reported as group

Quality

48.81

Promoting interoperability

100

Improvement activities

40

Cost

73.76

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Matthew D Barrows MD PA

  • Dermatology Physician
  • McKinney, TX
  • NPI 1699763490
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1942507207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 N STONEBRIDGE DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717437",
            "telephone_number": "972-390-9002",
            "fax_number": "214-491-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W RALPH HALL PKWY STE 102",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750328711",
            "telephone_number": "972-390-9002",
            "fax_number": "972-722-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHUN",
        "first_name": "MARISSA",
        "middle_name": "B",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "BOTHUN",
            "middle_name": "B",
            "credential": "P.A.-C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gary A Bonacquisti, MD
• Shatara Bonds
• Cassidy Booth
• Carol Boronkay, CRNA MHS, CFNP MS
• Shyona Boston
• Jolie Elisabeth Bowen, RBT
• Taylor Bowker, ATC
• Tiffany Bowman
• Michael Todd Boyce, OTR/L
• Luanne T Boyd, OT/L CHT

• Physician Assistant in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.