Marissa L Mascorro, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Tempe, Arizona. Her current practice location is
2120 S Mcclintock Dr, Suite 105, Tempe, Arizona. You can reach out to her office (for appointments etc.) via phone at
(480) 804-0326.
Marissa L Mascorro is licensed to practice in Arizona (license number PSY-005890) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063832343.
Healthcare Provider's Profile
| Full Name | Marissa L Mascorro |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 2120 S Mcclintock Dr, Tempe, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063832343
- Provider Enumeration Date: 04/24/2014
- Last Update Date: 05/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 3375061971
- Enrollment ID: I20250516003238
Medical Identifiers
Medical identifiers for Marissa L Mascorro such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063832343 | NPI | - | NPPES |
| 342848 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | LAC-13710 (Arizona) | Secondary |
| 101YP2500X | Counselor - Professional | LPC-17047 (Arizona) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY-005890 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Marissa L Mascorro allows following entities to bill medicare on her behalf.
| Entity Name | Knapp Neuropsychology |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922722917
PECOS PAC ID: 6709257959
Enrollment ID: O20230125002970 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marissa L Mascorro is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Marissa L Mascorro, PSYD
1400 E. Southern Ave, Ste. 735,
Tempe, AZ 85282-2692
Ph: (480) 804-0326 | Marissa L Mascorro, PSYD
2120 S Mcclintock Dr, Suite 105,
Tempe, AZ 85282-2692
Ph: (480) 804-0326 |
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