MARISSA MASTROCOLA
NPI 1790245884
Orthopaedic Surgery - Sports Medicine in Redwood City, CA

Q: What is Marissa Mastrocola's NPI number?

The NPI number for Marissa Mastrocola is 1790245884. It was assigned to this individual provider in the NPPES registry on March 23, 2019.

Q: What is Marissa Mastrocola's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Active since March 23, 2019PECOS EnrolledAccepts Medicare Assignment

450 BROADWAY ST # MC6342, REDWOOD CITY, CA 94063(650) 721-1836 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 2, 2025, Aug 13, 2024, Mar 23, 2019 (3 updates tracked since 2019).

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About Marissa Mastrocola NPPES

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

MARISSA MASTROCOLA (NPI 1790245884) is an individual sports medicine provider in Redwood City, California, licensed in Virginia (0101287702) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, is affiliated with Virginia Hospital Center, and is a graduate of University Of Massachusetts Medical School (2019).

NPPES Registry Identity

NPI1790245884

Entity TypeIndividualFemale

Primary Taxonomy207XX0005X

Provider Legal NameMARISSA MASTROCOLA

Location Address450 BROADWAY ST # MC6342Redwood City, CA 94063-3132

Mailing Address450 Broadway St # Mc6342Redwood City, CA 94063-3132 · (650) 721-1836

Phone(650) 721-1836

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2019

Enumeration DateMarch 23, 2019

Last NPPES UpdateDecember 2, 20253 updates tracked since enumeration

NPPES CertifiedDecember 2, 2025

✔ NPI 1790245884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in VA · 0101287702

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

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

450 BROADWAY ST # MC6342, Redwood City, CA 94063

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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

Marissa Mastrocola 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 ID2961738729

PECOS Enrollment IDI20251215000822

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

Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc

2,409 mi

Health Maintenance Organization

19450 DEERFIELD AVE
Lansdowne, VA 20176

Reassigned Medicare billing, Virginia and District of Columbia enrollments
Also billed through NPI 1831471713 (District of Columbia), NPI 1073678637 (District of Columbia), NPI 1114677572 (Virginia)
995 clinicians in this Medicare group

NPI 1225156367 (703) 726-2100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Virginia Hospital Center

Acute Care Hospitals · Arlington, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490050

Location1701 North George Mason DriveArlington, VA 22205 · Arlington County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES

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

JODY MARILYN LAW MD

Student in an Organized Health Care Education/Training Program

450 BROADWAY ST # MC6342
REDWOOD CITY, CA 94063

San Mateo County (650) 721-7638

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 Mastrocola's NPI number?

The NPI number for Marissa Mastrocola is 1790245884. It was assigned to this individual provider in the NPPES registry on March 23, 2019.

Where is Marissa Mastrocola located?

Marissa Mastrocola practices at 450 Broadway St # Mc6342, Redwood City, CA 94063. The listed phone number is (650) 721-1836.

What is Marissa Mastrocola's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Marissa Mastrocola enrolled in Medicare?

Yes. Marissa Mastrocola is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Marissa Mastrocola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marissa Mastrocola reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc (Lansdowne, VA). 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 Mastrocola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Marissa Mastrocola affiliated with any hospitals?

According to CMS data, Marissa Mastrocola is affiliated with Virginia Hospital Center.

When was this NPI record last updated?

The NPPES record for Marissa Mastrocola was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.