Individual provider Active NPI

Marissa Paige Macdonald, PA-C

  • Medical Physician Assistant
  • Lake View, NY
National Provider Identifier
1962397331
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
6496 Hackberry Dr
Lake View, NY 14085-9578
Phone
(716) 912-3514
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NY Primary

Addresses

Primary practice location

6496 Hackberry Dr
Lake View, NY 14085-9578

Mailing address

6496 Hackberry Dr
Lake View, NY 14085-9578
Phone (716) 912-3514

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
I20251031001713 NY Practitioner - Physician Assistant 6204325954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C. 395 clinicians

Practice addresses (Care Compare)

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Aug 25, 2025 Accepting new patients

Locations

3916 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 366-1215

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

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.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1962397331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6496 HACKBERRY DR",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859578",
            "telephone_number": "716-912-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6496 HACKBERRY DR",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859578",
            "telephone_number": "716-912-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MARISSA",
        "middle_name": "PAIGE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake View, NY

Sources for this page

Verify at the official NPI Registry.