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

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: July 19, 2026.

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

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 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
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.

450 BROADWAY ST # MC6342, Redwood City, CA 94063

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 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.

Other Providers at the Same Location NPPES 2

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

Student in an Organized Health Care Education/Training Program
450 BROADWAY ST # MC6342
REDWOOD CITY, CA 94063
Student in an Organized Health Care Education/Training Program
450 BROADWAY ST # MC6342
REDWOOD CITY, CA 94063

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790245884, enumerated as an "individual" on March 23, 2019.

The provider is located at 450 BROADWAY ST # MC6342 REDWOOD CITY, CA 94063 and the phone number is (650) 721-1836.

Orthopaedic Surgery with taxonomy code 207XX0005X and a focus in Sports Medicine.