MARISA BENEDICT (PA-C) – Physician Assistant, NPI 1174333868

MARISA BENEDICT (PA-C) is a healthcare provider. based in Saint petersburg, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9119512 (FL). The NPI Number for MARISA BENEDICT (PA-C) is 1174333868

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
MARISA BENEDICT (PA-C)
NPI
1174333868
Phone
Not provided
Address
1001 COUNTRY CLUB RD N
Enumeration Date
13 January 2025
Last Update Date
12 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7275287827
Graduation Year
2024 (2 years ago)
PAC ID
1951831395
Group Practice PAC ID
2961628615
Professional Enrollment ID
I20250213003465
Address ID
FL337107126ST640XXNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for MARISA BENEDICT (PA-C)

  • 1001 COUNTRY CLUB RD N

    SAINT PETERSBURG, FL 337104406

    Phone:

    Type: Mailing

  • 640 TYRONE BLVD N

    SAINT PETERSBURG, FL 337107126

    Phone: (727) 605-5591

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250213003465IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33710)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961628615View full group profile
NameSpecialtyState
Nurse PractitionerFL
-FL
Physician AssistantHI
Physician AssistantFL
Emergency MedicineFL

Reviews

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Frequently asked questions

Can I use this page to confirm MARISA BENEDICT (PA-C)'s NPI?
Yes. MARISA BENEDICT (PA-C) is listed with NPI 1174333868 in the public NPI dataset.
Does the file indicate MARISA BENEDICT (PA-C) is practicing under active NPI?
Directory data currently reports MARISA BENEDICT (PA-C) as active.
What healthcare role does MARISA BENEDICT (PA-C) hold?
Scheduling teams often label MARISA BENEDICT (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does MARISA BENEDICT (PA-C) serve?
MARISA BENEDICT (PA-C)'s listing highlights Saint Petersburg, Florida; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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