NPIMap

Individual provider Active NPI

Marisa Kolta Mendez, MS, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1992013445
Registry record updated Jan 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19123 Issued in CA
Practice address
6226 E Spring St Ste 100
Long Beach, CA 90815-1442
Phone
(562) 420-1338
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19123 CA Primary

Addresses

Primary practice location

6226 E Spring St Ste 100
Long Beach, CA 90815-1442

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

12401 Washington Blvd
Whittier, CA 90602-1006
Phone (562) 789-5401

Other names 1

  • Ms. Marisa Ruth Kolta Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000581 CA Practitioner - Physician Assistant 1355591546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthcare Partners Affiliates Medical GroupGroup PAC ID 7315842002, 775 clinicians

Practice addresses (Care Compare)

824 E Carson St
Suite 104
Carson, CA 90745-2262
Phone (310) 830-9706

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19123CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 13, 2015 Accepting new patients
Pih Health Physicians CurrentSince Sep 1, 2012 Accepting new patients
Pih Health Physicians CurrentSince Sep 1, 2012 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 13, 2015 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mmendez206999@westdirect.optum.com

Organizations & group practices 6

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 3

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": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1992013445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 E SPRING ST STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151442",
            "telephone_number": "562-420-1338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12401 Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906021006",
            "country_code": "US",
            "telephone_number": "562-789-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "MARISA",
        "middle_name": "KOLTA",
        "name_prefix": "Mrs.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "KOLTA",
            "middle_name": "RUTH",
            "prefix": "MS.",
            "credential": "MS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.