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

Marisa Halstead, PA

Individual provider Surgical Physician Assistant · NPI 1205305224

Marisa Halstead, PA is a Physician Assistant in Rochester, New York. Qualified in 2018, 8 years ago. Practices with Suny Health Science Center at Syracuse, a 210-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

30 N Union St Ste 105
Rochester, NY 14607-1345
Phone: (585) 232-8940
Fax: (585) 232-8687
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 022886 (NY)

Record details

NPI number1205305224
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 20, 2018
Last updated in NPPESDecember 18, 2023
Certification dateDecember 18, 2023

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 Suny Health Science Center At Syracuse — 210 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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