MARISSA M OLIVER RD
NPI 1104514389
Dietitian, Registered in Coon Rapids, MN

Q: What is Marissa Oliver's NPI number?

The NPI number for Marissa Oliver is 1104514389. It was assigned to this individual provider in the NPPES registry on April 26, 2023.

Q: What is Marissa Oliver's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Marissa Oliver was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2023Accepts Medicare Assignment

9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433(763) 780-9155(763) 236-1066 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 22, 2025, Feb 19, 2025, Jun 1, 2023 (3 updates tracked since 2023).

On this page

About Marissa M Oliver Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA M OLIVER RD (NPI 1104514389) is an individual dietitian, registered in Coon Rapids, Minnesota, licensed in Minnesota (3854) and active in the NPI registry since April 2023. She is a graduate of Other (2016).

NPPES Registry Identity

NPI1104514389

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameMARISSA M OLIVERCredential: RD

Location Address9055 SPRINGBROOK DR NWCoon Rapids, MN 55433-5841

Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000

Phone(763) 780-9155

Fax(763) 236-1066

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 26, 2023

Last NPPES UpdateMay 22, 20253 updates tracked since enumeration

NPPES CertifiedMay 22, 2025

✔ NPI 1104514389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in MN · 3854

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

9055 SPRINGBROOK DR NW, Coon Rapids, MN 55433

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marissa M Oliver Rd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880051242

PECOS Enrollment IDI20230531001530

Medicare Billing Reassignment

Medicare enrollment records show Marissa Oliver reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Allina Health System

Same address

Family Medicine

9055 SPRINGBROOK DR NW
Coon Rapids, MN 55433

Reassigned Medicare billing, Minnesota enrollment
2,609 clinicians in this Medicare group

NPI 1295031649 (763) 780-9155

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55433 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLYTHE ELLEN NELSON LICSW

Social Worker (Clinical)