MARISSE HERRERA D.O.
NPI 1134564198
Family Medicine in Fullerton, CA
NPI Status: Active since May 05, 2013
Contact Information
1440 N HARBOR BLVD STE 110
FULLERTON, CA
ZIP 92835
Phone: (657) 212-3212
- Individual
- Female
- Family Medicine
- PECOS Enrolled
- Opted-Out Medicare
About MARISSE HERRERA
This page provides the complete NPI Profile along with additional information for Marisse Herrera, a primary care provider established in Fullerton, California with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1134564198 assigned on May 2013. The practitioner's primary taxonomy code is 207Q00000X with license number 20A13853 (CA). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1134564198
- Provider Name
- MARISSE HERRERA D.O.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1440 N HARBOR BLVD STE 110 FULLERTON, CA 92835
- Location Phone
- (657) 212-3212
- Mailing Address
- 1440 N HARBOR BLVD STE 110 FULLERTON, CA 92835
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-05-2013
- Last Update Date
- 08-10-2022
- Code Navigator
A primary care provider (PCP) like Marisse Herrera sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Marisse Herrera opted out of Medicare effective on 07-11-2022 until 07-11-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 20A13853
- License State
- CA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Medicare Participation & PECOS Enrollment Status
Marisse Herrera is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-11-2022
Opt-Out End Date: 07-11-2026
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 92835 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $96.36
- Minimum New Patient Price $62.96
- Maximum New Patient Price $187.6
- Average New Patient Copayment $24.09
- Minimum New Patient Copayment $15.74
- Maximum New Patient Copayment $46.9
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $109.96
- Minimum Established Patient Price $20.84
- Maximum Established Patient Price $153.61
- Average Established Patient Copayment $27.49
- Minimum Established Patient Copayment $5.21
- Maximum Established Patient Copayment $38.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 3 | 4 | 5 | 6 | 4 | 1 | 9 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 6 | 4 | 10 | 6 | 8 | 1 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 6 + 4 + 1 + 0 + 6 + 8 + 1 + 1 + 8 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1134564198 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1750032082 | KEVIN OEI D.O. MEDICAL CORP Organization | Family Medicine | 1440 N HARBOR BLVD STE 110 FULLERTON, CA 92835 (657) 212-3212 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1134564198, enumerated in the NPI registry as an "individual" on May 05, 2013
The provider is located at 1440 N Harbor Blvd Ste 110 Fullerton, Ca 92835 and the phone number is (657) 212-3212
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $96.36 with an average copayment of $24.09 for new patient appointments. Established patients should expect a typical charge of $109.96 and an average copayment of 27.49. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on July 11, 2022 to opt-out of the Medicare program. The provider is excluded from the Medicare program until July 11, 2026.
This NPI record was last updated on May 05, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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