Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marissa Jodi McClintock, PA-C

Individual provider Physician Assistant · NPI 1861470338

Marissa Jodi McClintock, PA-C is a Physician Assistant in Ithaca, New York. Qualified in 2004, 22 years ago. Practices with Sports Medicine North Orthopaedic Surgery, Inc, a 86-clinician group and accepts Medicare assignment. Licensed in Massachusetts and New York.

Years since qualifying
22
Licensed in
MA, NY
In the registry since
2006
Specialties on file
2
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

107 Cayuga Heights Rd Apt 11
Ithaca, NY 14850-2152
Phone: (617) 990-4085
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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 011434 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 1812 (MA)

Record details

NPI number1861470338
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2006
Last updated in NPPESOctober 10, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Sports Medicine North Orthopaedic Surgery, Inc. — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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