DR. MARISA JANE WICKERATH MD
NPI 1962088641
Family Medicine in Forest Grove, OR

Active since March 22, 2021PECOS EnrolledAccepts Medicare Assignment
1825 MAPLE ST, FOREST GROVE, OR 97116(503) 357-2136 Get Directions Write a Review

NPPES record last updated: October 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 1, 2024, Jun 29, 2024, May 20, 2021 and 1 more (4 updates tracked since 2021).

About Dr. Marisa Jane Wickerath Md NPPES

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

DR. MARISA JANE WICKERATH MD (NPI 1962088641) is an individual family medicine provider in Forest Grove, Oregon, licensed in Oregon (MD221260) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with Ohsu Hospital And Clinics, and maintains a secondary practice location in Goldendale.

NPPES Registry Identity

NPI1962088641
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARISA JANE WICKERATHCredential: MD
Location Address1825 MAPLE STForest Grove, OR 97116-1939
Mailing Address1400 Sw 5th Ave Ste 500Portland, OR 97201-5537 · Fax (503) 346-8021
Sole ProprietorNo
Medical School CMSUniversity Of Washington School Of MedicineGraduated 2021
Enumeration DateMarch 22, 2021
Last NPPES UpdateOctober 23, 20244 updates tracked since enumeration
NPPES CertifiedOctober 23, 2024
NPI 1962088641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in OR · MD221260
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency MedicineTaxonomy 207P00000X · License MD61556041 (WA)
1825 MAPLE ST, Forest Grove, OR 97116

Secondary Practice Location 1

Location 1310 S Roosevelt StGoldendale, WA 98620-9201 · Phone (509) 773-4022

Accepted Insurance

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

Dr. Marisa Jane Wickerath Md 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 ID7810391703
PECOS Enrollment IDI20240917003523
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.

Hospital Affiliations CMS Care Compare 2

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

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

Hillsboro Medical Center

Acute Care Hospitals · Hillsboro, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380021
Location335 SE 8th AvenueHillsboro, OR 97123 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97116 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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 12

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

Family Medicine
1825 MAPLE ST
FOREST GROVE, OR 97116
Physician Assistant (Medical)
1825 MAPLE ST
FOREST GROVE, OR 97116
Pediatrics
1825 MAPLE ST
FOREST GROVE, OR 97116
Family Medicine
1825 MAPLE ST
FOREST GROVE, OR 97116
Physician Assistant (Medical)
1825 MAPLE ST
FOREST GROVE, OR 97116
Physician Assistant
1825 MAPLE ST
FOREST GROVE, OR 97116
Physician Assistant
1825 MAPLE ST
FOREST GROVE, OR 97116
Family Medicine
1825 MAPLE ST
FOREST GROVE, OR 97116

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 Marisa Wickerath's NPI number?

The NPI number for Marisa Wickerath is 1962088641. It was assigned to this individual provider in the NPPES registry on March 22, 2021.

Where is Marisa Wickerath located?

Marisa Wickerath practices at 1825 Maple St, Forest Grove, OR 97116. The listed phone number is (503) 357-2136.

What is Marisa Wickerath's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Marisa Wickerath enrolled in Medicare?

Yes. Marisa Wickerath 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.

What insurance does Marisa Wickerath accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Marisa Wickerath as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Marisa Wickerath affiliated with any hospitals?

According to CMS data, Marisa Wickerath is affiliated with Ohsu Hospital And Clinics and Hillsboro Medical Center.

When was this NPI record last updated?

The NPPES record for Marisa Wickerath was last updated on October 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.