Marissa Rose Mezzatesta, PA-C
NPI 1376429241ActiveIndividual· Physician Assistant· Glendale, AZ
Physician Assistant (PA-C) with Banner - University Physician Specialists LLC, practicing in Glendale, Arizona. Enrolled in Medicare as practitioner - physician assistant. Lists Banner - University Medical Center Phoenix and 1 other hospital as hospital affiliations.
Overview
| NPI | 1376429241 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Aug 14, 2025 |
| Last updated in NPPES | Jan 14, 2026 |
| Certified by provider | Jan 14, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (AZ) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Banner - University Physician Specialists LLCPhoenix, AZ · 348 clinicians
Hospital affiliations
- Banner - University Medical Center PhoenixPhoenix, AZ
- Banner Thunderbird Medical CenterGlendale, AZ
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 171 physician assistants in Glendale · All physician assistants in Arizona