MARIANNE LISSADE AGNP-C
NPI 1780036152
Nurse Practitioner - Adult Health in Stone Mountain, GA

Q: What is Marianne Lissade's NPI number?

The NPI number for Marianne Lissade is 1780036152. It was assigned to this individual provider in the NPPES registry on July 8, 2016.

Q: What is Marianne Lissade's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Marianne Lissade was last updated on January 22, 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.

Active since July 08, 2016PECOS EnrolledAccepts Medicare Assignment

1825 ROCKBRIDGE RD STE 15B, STONE MOUNTAIN, GA 30087(470) 444-3134(470) 276-4370 Get Directions Write a Review

NPPES record last updated: January 22, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Marianne Lissade Agnp-c NPPES

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

MARIANNE LISSADE AGNP-C (NPI 1780036152) is an individual adult health provider in Stone Mountain, Georgia, licensed in Georgia (RN147281) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Winder, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1780036152

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMARIANNE LISSADECredential: AGNP-C

Location Address1825 ROCKBRIDGE RD STE 15BStone Mountain, GA 30087-3306

Mailing AddressPo Box 740015Atlanta, GA 30374-0015 · (312) 733-9730

Phone(470) 444-3134

Fax(470) 276-4370

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJuly 8, 2016

Last NPPES UpdateJanuary 22, 2024

NPPES CertifiedJanuary 22, 2024

✔ NPI 1780036152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in GA · RN147281

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License RN147281 (GA)

1825 ROCKBRIDGE RD STE 15B, Stone Mountain, GA 30087

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Secondary Practice Location 1

Location 1133 W Athens StWinder, GA 30680-1786 · Phone (770) 867-6633

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

Marianne Lissade Agnp-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 ID7517250400

PECOS Enrollment IDI20160729001966

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 Marianne Lissade reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Center For Pan Asian Community Services, Inc.

9.4 mi

Federally Qualified Health Center (FQHC)

6185 BUFORD HWY BLDG B
Peachtree Corners, GA 30071

Reassigned Medicare billing, Georgia enrollment
3 clinicians in this Medicare group

NPI 1336493311 (770) 936-0969

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 30087 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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 17

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

MS. KENISHA FRANCISCO APRN

Nurse Practitioner (Family)