DR. MARISSA NICOLE PELLEGRINO (PH.D.) – Psychologist, NPI 1699836932

DR. MARISSA NICOLE PELLEGRINO (PH.D.) is a healthcare provider. based in Princeton, New Jersey. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. The NPI Number for DR. MARISSA NICOLE PELLEGRINO (PH.D.) is 1699836932

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARISSA NICOLE PELLEGRINO (PH.D.)
NPI
1699836932
Phone
(609) 895-1070
Address
100 CANAL POINTE BLVD STE 210
Enumeration Date
12 December 2006
Last Update Date
14 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6098951070
Graduation Year
2006 (20 years ago)
PAC ID
2860842051
Group Practice PAC ID
5294774105
Professional Enrollment ID
I20231229002915
Address ID
NJ085407169PR100XXBLVD401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:19State licenses:0Digital endpointsOther names

963 CLINICAL PSYCHOLOGIST in NJ

Provider Addresses for DR. MARISSA NICOLE PELLEGRINO (PH.D.)

  • 100 CANAL POINTE BLVD STE 210

    PRINCETON, NJ 085407169

    Phone: (609) 895-1070

    Type: Location

  • 230, West Maple Avenue, Enid, Garfield County, Oklahoma, 73701, United States

    ENID, OK 737014012

    Phone: (580) 242-5544

    Type: Mailing

  • 45 W SHORE DR

    PENNINGTON, NJ 085342122

    Phone: (609) 737-6896

    Type: Mailing

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: 2023-12-29

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
I20231229002915IClinical PsychologistNJTBD

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 08540)

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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: 5294774105View full group profile
NameSpecialtyState
Clinical PsychologistNJ
Clinical PsychologistNJ

Reviews

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Frequently asked questions

How do payers reference DR. MARISSA NICOLE PELLEGRINO (PH.D.)?
For DR. MARISSA NICOLE PELLEGRINO (PH.D.), use NPI 1699836932 as the unique 10-digit identifier.
Would DR. MARISSA NICOLE PELLEGRINO (PH.D.) appear as active to a payer?
You can treat DR. MARISSA NICOLE PELLEGRINO (PH.D.) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. MARISSA NICOLE PELLEGRINO (PH.D.)?
DR. MARISSA NICOLE PELLEGRINO (PH.D.)'s record emphasizes Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. MARISSA NICOLE PELLEGRINO (PH.D.) located near Princeton?
DR. MARISSA NICOLE PELLEGRINO (PH.D.) currently maps to Princeton, New Jersey in this extract.
Can I trust this NPI listing for DR. MARISSA NICOLE PELLEGRINO (PH.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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