MARISSA ROBIN JENNINGS PA-C
NPI 1245979095
Physician Assistant - Medical in Los Angeles, CA

Q: What is Marissa Jennings's NPI number?

The NPI number for Marissa Jennings is 1245979095. It was assigned to this individual provider in the NPPES registry on May 31, 2022.

Q: What is Marissa Jennings's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Marissa Jennings was last updated on June 21, 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 May 31, 2022PECOS EnrolledAccepts Medicare Assignment

808 W 58TH ST, LOS ANGELES, CA 90037(323) 541-1600 Get Directions Write a Review

NPPES record last updated: June 21, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 21, 2023, Nov 3, 2022 (2 updates tracked since 2022).

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About Marissa Robin Jennings Pa-c NPPES

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

MARISSA ROBIN JENNINGS PA-C (NPI 1245979095) is an individual medical provider in Los Angeles, California, licensed in California (62675) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1245979095

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMARISSA ROBIN JENNINGSCredential: PA-C

Location Address808 W 58TH STLos Angeles, CA 90037-3632

Mailing Address3324 Castle Heights Ave Apt 109Los Angeles, CA 90034-2736 · (704) 999-5827

Phone(323) 541-1600

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateMay 31, 2022

Last NPPES UpdateJune 21, 20232 updates tracked since enumeration

NPPES CertifiedJune 21, 2023

✔ NPI 1245979095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in CA · 62675✔ Licensed in SC · 4517

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

808 W 58TH ST, Los Angeles, CA 90037

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Secondary Practice Locations 2

Location 12810 Ashley Phosphate RdNorth Charleston, SC 29418-6405 · Phone (843) 553-7744

Location 25834 SW 9th PlGainesville, FL 32607-3891 · Phone (704) 999-5827

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marissa Robin Jennings Pa-c 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 ID648639419

PECOS Enrollment IDI20230711003954

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.

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.

TAMMY SUE TOWNS APRN

Nurse Practitioner (Women's Health)