Active NPI
Marissa E Jones, PA
- Physician Assistant
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10002481A
- Practice address
- 7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609 - Phone
- (317) 621-5676
- Fax
- (317) 621-5678
- NPI assigned
- Jun 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10002481A | IN | Primary |
Addresses
Primary practice location
7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609
Mailing address
6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7588
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P02085718 | Other | IN | MEDICARE RAILROAD |
| 300016561 | Medicaid | IN | |
| 266180C01 | Other | IN | TRADITIONAL MEDICARE |
Other names 1
- Marissa Ehrlich
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 N Ritter Ave
Indianapolis, IN 46219-3027
7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
7250 Clearvista Dr
Ste 355
Indianapolis, IN 46256
Phone (317) 621-5673
Interoperability endpoints
- mehrlich219998@ecommunitydirect.com
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1952895898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502890",
"telephone_number": "317-621-7588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7250 CLEARVISTA DR STE 355",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462565609",
"telephone_number": "317-621-5676",
"fax_number": "317-621-5678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "MARISSA",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-14",
"last_updated": "2023-07-24",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10002481A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P02085718",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300016561",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRADITIONAL MEDICARE",
"identifier": "266180C01",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARISSA",
"last_name": "EHRLICH",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.