DR. MARISA ELIZABETH PATT DMD
NPI 1124331004
Dentist - Prosthodontics in Boulder, CO

Q: What is Marisa Patt's NPI number?

The NPI number for Marisa Patt is 1124331004. It was assigned to this individual provider in the NPPES registry on July 20, 2010.

Q: What is Marisa Patt's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Q: Is Marisa Patt enrolled in Medicare?

No. Marisa Patt has opted out of Medicare through July 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Marisa Patt was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 20, 2010Opted out of Medicare · through Jul 16, 2028

7490 CLUBHOUSE RD STE 101, BOULDER, CO 80301(303) 530-1212 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

On this page

About Dr. Marisa Elizabeth Patt Dmd NPPES

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

DR. MARISA ELIZABETH PATT DMD (NPI 1124331004) is an individual prosthodontics provider in Boulder, Colorado, licensed in Colorado (00203089) and active in the NPI registry since July 2010. She has opted out of Medicare through July 16, 2028 and remains eligible to order and refer and maintains a secondary practice location in Boulder.

NPPES Registry Identity

NPI1124331004

Entity TypeIndividualFemale

Primary Taxonomy1223P0700X

Provider Legal NameDR. MARISA ELIZABETH PATTCredential: DMD

Location Address7490 CLUBHOUSE RD STE 101Boulder, CO 80301-3720

Mailing Address595 Madison Ave, Ste 1208New York, NY 10022-1907 · (212) 371-3311

Phone(303) 530-1212

Sole ProprietorYes

Enumeration DateJuly 20, 2010

Last NPPES UpdateJuly 6, 2023

NPPES CertifiedJune 27, 2023

✔ NPI 1124331004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers

Taxonomy Code1223P0700X

License✔ Licensed in CO · 00203089

Definition

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

7490 CLUBHOUSE RD STE 101, Boulder, CO 80301

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Secondary Practice Location 1

Location 15400 Idylwild Trl, Suite ABoulder, CO 80301 · Phone (303) 530-1212

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Marisa Elizabeth Patt Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 16, 2018 through July 16, 2028.

Opt-Out Effective DateJuly 16, 2018

Opt-Out In Effect ThroughJuly 16, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80301 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

$89.43 typical visit price

range $58.06 – $174.82

Typical copayment $22.35 (range $14.51 – $43.70)

Most-billed visit code 99203

Established Patient

$72.20 typical visit price

range $18.88 – $142.79

Typical copayment $18.05 (range $4.72 – $35.69)

Most-billed visit code 99213

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

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 Marisa Patt's NPI number?

The NPI number for Marisa Patt is 1124331004. It was assigned to this individual provider in the NPPES registry on July 20, 2010.

Where is Marisa Patt located?

Marisa Patt practices at 7490 Clubhouse Rd Ste 101, Boulder, CO 80301. The listed phone number is (303) 530-1212.

What is Marisa Patt's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Is Marisa Patt enrolled in Medicare?

No. Marisa Patt has opted out of Medicare through July 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Marisa Patt was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.