Marissa Lee Fahrbach, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Boulder, Colorado. Her current practice location is
1755 48th St Ste 100, Boulder, Colorado. You can reach out to her office (for appointments etc.) via phone at
(303) 604-5000.
Marissa Lee Fahrbach is licensed to practice in Colorado (license number 0994226) 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 1427430032.
Provider's Profile
| Full Name | Marissa Lee Fahrbach |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1755 48th St Ste 100, Boulder, Colorado |
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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: 1427430032
- Provider Enumeration Date: 06/19/2015
- Last Update Date: 03/05/2020
Medicare PECOS Information:
- PECOS PAC ID: 9931419181
- Enrollment ID: I20181219000859
Medical Identifiers
Medical identifiers for Marissa Lee Fahrbach such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427430032 | NPI | - | NPPES |
| 9000171761 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 103068 (Kansas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 557356 (Kansas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 0994226 (Colorado) | 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 Lee Fahrbach allows following entities to bill medicare on her behalf.
| Entity Name | Boulder Valley Gastroenterology Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902832603
PECOS PAC ID: 4688577174
Enrollment ID: O20040130001035 |
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| Entity Name | North Denver Anesthesia Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902624422
PECOS PAC ID: 9234667346
Enrollment ID: O20250116001345 |
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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 Lee Fahrbach 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 Lee Fahrbach,
382 S Arthur Ave,
Louisville, CO 80027-3094
Ph: (303) 604-5000 | Marissa Lee Fahrbach,
1755 48th St Ste 100,
Boulder, CO 80301-2712
Ph: (303) 604-5000 |
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