Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marisa Ann Yates, PA-C

Individual provider Physician Assistant · NPI 1205306156

Marisa Ann Yates, PA-C is a Physician Assistant in Watertown, New York. Qualified in 2018, 8 years ago. Practices with Samaritan Medical Center, a 158-clinician group and accepts Medicare assignment. Licensed in Missouri, North Carolina and New York.

Years since qualifying
8
Licensed in
MO, NC, NY
In the registry since
2018
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1575 Washington St
Watertown, NY 13601-9371
Phone: (315) 785-4155
Fax: (315) 779-5066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 026591-01 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 0010-08509 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 2020017114 (MO)

Record details

NPI number1205306156
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 3, 2018
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Samaritan Medical Center — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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