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MARISSA MALIAKAL ANTO M.D.
NPI 1114380128
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Philadelphia, PA

Active since March 29, 2016PECOS Enrolled
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC HEADACHE MEDICINE, PHILADELPHIA, PA 19104(267) 825-3170 Get Directions Write a Review

NPPES record last updated: July 12, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 12, 2021, Mar 29, 2016 (2 updates tracked since 2016).

About Marissa Maliakal Anto M.d. NPPES

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

MARISSA MALIAKAL ANTO M.D. (NPI 1114380128) is an individual neurology with special qualifications in child neurology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD472478) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114380128
Entity TypeIndividualFemale
Primary Taxonomy2084N0402X
Provider Legal NameMARISSA MALIAKAL ANTOCredential: M.D.
Location Address3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC HEADACHE MEDICINEPhiladelphia, PA 19104
Mailing Address41 Windsor DrJericho, NY 11753-1327 · (516) 661-5143
Phone(267) 825-3170
Sole ProprietorNo
Enumeration DateMarch 29, 2016
Last NPPES UpdateJuly 12, 20212 updates tracked since enumeration
NPPES CertifiedJuly 12, 2021
✔ NPI 1114380128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in PA · MD472478
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marissa Maliakal Anto M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Anto's NPI number?

The NPI number for Marissa Anto is 1114380128. It was assigned to this individual provider in the NPPES registry on March 29, 2016.

Where is Marissa Anto located?

Marissa Anto practices at 3401 Civic Center Blvd Division Of Pediatric Headache Medicine, Philadelphia, PA 19104. The listed phone number is (267) 825-3170.

What is Marissa Anto's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Marissa Anto enrolled in Medicare?

Yes. Marissa Anto is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marissa Anto was last updated on July 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.