Marisa Rene Fullgrapp, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114046 Issued in FL

Practice address

6110 State Road 70 E
Bradenton, FL 34203-9712

Phone

(941) 755-4242

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Medical Specialists LLCGroup PAC ID 5799786687, 125 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Florida Medical Specialists LLC

  • Hematology & Oncology Physician
  • Sarasota, FL
  • NPI 1750399598
  Medicare reassignment Care Compare group
• Florida Medical Specialists LLC

  • Hematology & Oncology Physician
  • Lakewood Ranch, FL
  • NPI 1891419925
  NPD
• Florida Medical Specialists, LLC

  • Family Medicine Physician
  • North Port, FL
  • NPI 1013550102
  NPD
• Best Value Healthcare LLC

  • Internal Medicine Physician
  • Clearwater, FL
  • NPI 1790152015
  NPD (past)
• Coastal Cardiovascular Consultants PLLC

  • Cardiovascular Disease Physician
  • Bradenton, FL
  • NPI 1194106385
  NPD (past)
• Florida Medical Specialists LLC

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1164795563
  NPD (past)
• Florida Medical Specialists LLC

  • Internal Medicine Physician
  • Bradenton, FL
  • NPI 1699163808
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1992399026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 TALBOT PL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342416148",
            "telephone_number": "941-780-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 STATE ROAD 70 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342039712",
            "telephone_number": "941-755-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLGRAPP",
        "first_name": "MARISA",
        "middle_name": "RENE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Richard Froug, DMD
• Bernadette Anita Frye, APRN
• Rachelle Fuchs
• Yelenis Fuertes Yanes
• Debora Fuertes-Pacheco
• Fullness of Life Counseling, LLC
• Carly Dion Fultz, PTA
• Functional Interventions Therapy, P.a.
• Susan Funk, OTR/L
• Beth Funtal, FDNP, CCLC

• Physician Assistant in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.