MARISSA DACRUZ (PA-S) – Family Medicine Physician, NPI 1134849953

MARISSA DACRUZ (PA-S) is a healthcare provider. based in West roxbury, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-S. They hold a License No. PA01647 (RI). The NPI Number for MARISSA DACRUZ (PA-S) is 1134849953

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MARISSA DACRUZ (PA-S)
NPI
1134849953
Phone
(203) 908-5196
Address
5050 WASHINGTON ST APT 216
Enumeration Date
31 August 2022
Last Update Date
28 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4017220081
Graduation Year
2023 (3 years ago)
PAC ID
1951844356
Group Practice PAC ID
8628045762
Professional Enrollment ID
I20240613001925
Address ID
RI028632005CE9XXXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

5,131 PHYSICIAN ASSISTANT in MA

Provider Addresses for MARISSA DACRUZ (PA-S)

  • 5050 WASHINGTON ST APT 216

    WEST ROXBURY, MA 021324744

    Phone: (203) 908-5196

    Type: Mailing

  • 360 HUNTINGTON AVE

    BOSTON, MA 021155005

    Phone: (617) 373-2000

    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: 2024-06-13

PECOS data refreshed: 2026-06-15

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
I20240613001925IPhysician AssistantRITBD

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 02132)

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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: 8628045762View full group profile
NameSpecialtyState
Family PracticeRI
Family PracticeRI
Clinical Social WorkerRI
Physician AssistantRI
Nurse PractitionerRI
Family PracticeRI
Physician AssistantRI
Family PracticeRI
Nurse PractitionerMA
Family Practice, Nurse PractitionerMD

Reviews

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Frequently asked questions

What NPI should I save for MARISSA DACRUZ (PA-S)?
Save NPI 1134849953 if you need a stable reference for MARISSA DACRUZ (PA-S).
Does this profile mean MARISSA DACRUZ (PA-S) is currently active?
Yes — MARISSA DACRUZ (PA-S) appears active in the national provider directory.
What kind of provider is MARISSA DACRUZ (PA-S)?
The page reflects Family Medicine Physician for MARISSA DACRUZ (PA-S). Clinical services aligned with this taxonomy classification.
Does MARISSA DACRUZ (PA-S) practice in Massachusetts?
You will see West Roxbury, Massachusetts on file for MARISSA DACRUZ (PA-S) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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