MARISSA J HERNANDEZ (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104164417

MARISSA J HERNANDEZ (CRNA) is a healthcare provider. based in Wausau, Wisconsin. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 0001241907 (VA). The NPI Number for MARISSA J HERNANDEZ (CRNA) is 1104164417

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MARISSA J HERNANDEZ (CRNA)
NPI
1104164417
Phone
(715) 847-2558
Address
411 WESTWOOD DR
Enumeration Date
21 January 2013
Last Update Date
21 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7158472558
Graduation Year
2012 (14 years ago)
PAC ID
7012152838
Group Practice PAC ID
4385677814
Professional Enrollment ID
I20180915000000
Address ID
WI544014152WA411XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:13State licenses:2Digital endpointsOther names

1,141 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WI

Provider Addresses for MARISSA J HERNANDEZ (CRNA)

  • 411 WESTWOOD DR

    WAUSAU, WI 544014152

    Phone: (715) 847-2558

    Fax: (715) 847-2557

    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)

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: 2018-09-15

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180915000000ICertified Registered Nurse Anesthetist (Crna)WITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00145Anesthesia for retinal surgery2626$0
00142Anesthesia for lens surgery2525$0
00811Anesthesia for other procedure on large bowel using an endoscope2121$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1919$0
00812Anesthesia for exam of colon using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 54401)

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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: 4385677814View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
G A S T R O E N T E R O L O G YWI
P A T H O L O G YWI
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)WI
G A S T R O E N T E R O L O G YWI
G A S T R O E N T E R O L O G YWI
Gastroenterology, Internal Medicine, Geriatric MedicineWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

Is MARISSA J HERNANDEZ (CRNA) listed with a National Provider Identifier?
Yes — MARISSA J HERNANDEZ (CRNA) has NPI 1104164417 on file in the registry.
Active or inactive — what applies to MARISSA J HERNANDEZ (CRNA)?
You should see MARISSA J HERNANDEZ (CRNA) as active in CMS-hosted NPPES data.
What kind of doctor is MARISSA J HERNANDEZ (CRNA)?
MARISSA J HERNANDEZ (CRNA) is associated with Certified Registered Nurse Anesthetist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for MARISSA J HERNANDEZ (CRNA)?
Travel planning: use Wausau, Wisconsin as the reference point for MARISSA J HERNANDEZ (CRNA), then confirm.
Can I trust this NPI listing for MARISSA J HERNANDEZ (CRNA)?
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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