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MARISSA ASHLEY WILLOUGHBY-NAIDITCH NP
NPI 1194283911
Nurse Practitioner - Family in Brooklyn, NY

Active since March 11, 2019PECOS Enrolled
1125 CARROLL ST, BROOKLYN, NY 11225(646) 901-0994 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 7, 2024, Aug 13, 2021, Dec 30, 2020 and 1 more (4 updates tracked since 2019).

About Marissa Ashley Willoughby-naiditch Np NPPES

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

MARISSA ASHLEY WILLOUGHBY-NAIDITCH NP (NPI 1194283911) is an individual family provider in Brooklyn, New York, licensed in New York (344027) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Brooklyn.

NPPES Registry Identity

NPI1194283911
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARISSA ASHLEY WILLOUGHBY-NAIDITCHCredential: NP
Location Address1125 CARROLL STBrooklyn, NY 11225-2202
Mailing Address6255 W Sunset Blvd Fl 21Los Angeles, CA 90028-7422 · (323) 860-5200 · Fax (323) 467-7119
Phone(646) 901-0994
Sole ProprietorNo
Enumeration DateMarch 11, 2019
Last NPPES UpdateMay 7, 20244 updates tracked since enumeration
NPPES CertifiedMay 7, 2024
✔ NPI 1194283911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 344027
1125 CARROLL ST, Brooklyn, NY 11225
Open in Google Maps ↗

Secondary Practice Location 1

Location 1475 Atlantic Ave Ste 2Brooklyn, NY 11217-4383 · Phone (718) 369-4850 · Fax (718) 369-4851

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marissa Ashley Willoughby-naiditch Np 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.

Medicare Billing Reassignment

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

Ajs Brooklyn Medical Practice PC
2.0 mi
Clinic/Center
475 ATLANTIC AVE, SECOND FLOOR
Brooklyn, NY 11217
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Mvp Medical Practice PC
  • 30 clinicians in this Medicare group
NPI 1558707299 (718) 369-4850

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 11225 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Willoughby-naiditch's NPI number?

The NPI number for Marissa Willoughby-naiditch is 1194283911. It was assigned to this individual provider in the NPPES registry on March 11, 2019.

Where is Marissa Willoughby-naiditch located?

Marissa Willoughby-naiditch practices at 1125 Carroll St, Brooklyn, NY 11225. The listed phone number is (646) 901-0994.

What is Marissa Willoughby-naiditch's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Marissa Willoughby-naiditch enrolled in Medicare?

Yes. Marissa Willoughby-naiditch is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Marissa Willoughby-naiditch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marissa Willoughby-naiditch reassigns Medicare benefits to Ajs Brooklyn Medical Practice PC (Brooklyn, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marissa Willoughby-naiditch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Marissa Willoughby-naiditch was last updated on May 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.