MRS. MARIANNE DOLORES MCKISSICK (PAC) – Physician Assistant, NPI 1710154521
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. MARIANNE DOLORES MCKISSICK (PAC)
3350, Gratiot Boulevard, Marysville, Saint Clair County, Michigan, 48040, United States
MARYSVILLE, MI 480402121
Phone: (810) 364-4000
Fax: (810) 364-5995
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 47 Open Payments records for all available years, with a total value of $774.
Total Amount is formed as General ($774) + Research ($0) + Ownership ($0) = $774.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Lilly USA, LLC ($265).
Total Amount
$774
General + Research + Ownership
Payments
47
Total payment records
General Amount
$774
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $265 |
| Novo Nordisk Inc | $61 |
| Merck Sharp & Dohme LLC | $58 |
| Amgen Inc. | $44 |
| Exact Sciences Corporation | $42 |
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: 2004-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040615001184 | I | Physician Assistant | MI | TBD |
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.
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 48040)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine | MI | |
| Nurse Practitioner | MI | |
| - | MI |
Reviews
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