Marissa Fowler, CNP is a medicare enrolled "Nurse Practitioner" in Chesterland, Oh, Ohio. Her current practice location is
12265 Shioh Dr, Chesterland, Oh, Ohio. You can reach out to her office (for appointments etc.) via phone at
(440) 665-9274.
Marissa Fowler is licensed to practice in Ohio (license number APRN.CNP.0030311) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780341057.
Provider's Profile
| Full Name | Marissa Fowler |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 12265 Shioh Dr, Chesterland, Oh, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1780341057
- Provider Enumeration Date: 11/22/2021
- Last Update Date: 03/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 7719370956
- Enrollment ID: I20220210000532
Medical Identifiers
Medical identifiers for Marissa Fowler such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780341057 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | APRN.CNP.0030311 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Marissa Fowler allows following entities to bill medicare on her behalf.
| Entity Name | University Primary Care Practices Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003935339
PECOS PAC ID: 3072417534
Enrollment ID: O20031125000767 |
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| Entity Name | Suhas Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811508625
PECOS PAC ID: 7012337629
Enrollment ID: O20201021000825 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marissa Fowler is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Marissa Fowler, CNP
150 Center St,
Chardon, OH 44024-1179
Ph: () - | Marissa Fowler, CNP
12265 Shioh Dr,
Chesterland, Oh, OH 44026
Ph: (440) 665-9274 |
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