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

Individual provider Physician Assistant · NPI 1376429241

Marissa Rose Mezzatesta, PA-C is a Physician Assistant in Glendale, Arizona. Qualified in 2025, 1 year ago. Practices with Banner - University Physician Specialists LLC, a 347-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2025
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

5310 W Thunderbird Rd Ste 308
Glendale, AZ 85306-4710
Phone: (602) 462-0469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (AZ)

Record details

NPI number1376429241
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 14, 2025
Last updated in NPPESJanuary 14, 2026
Certification dateJanuary 14, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Banner - University Physician Specialists Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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