Individual provider Active NPI

Cissy Elizabeth Bassett, CRNP

  • Family Nurse Practitioner
  • Indiana, PA
National Provider Identifier
1013490739
Registry record updated Sep 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018751 Issued in PA
Practice address
2501 Warren Rd
Indiana, PA 15701-3280
Phone
(724) 349-5620
NPI assigned
Sep 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018751 PA Primary

Addresses

Primary practice location

2501 Warren Rd
Indiana, PA 15701-3280

Mailing address

537 5TH Ave
Avonmore, PA 15618-1252
Phone (724) 882-4135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181213001561 PA Practitioner - Nurse Practitioner 8426393893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018751PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Dec 1, 2022 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

100 S Juniper St
Fl 3
Philadelphia, PA 19107
Phone (267) 999-9534

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536451200000",
    "number": "1013490739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 5TH AVE",
            "city": "AVONMORE",
            "state": "PA",
            "postal_code": "156181252",
            "telephone_number": "724-882-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WARREN RD",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013280",
            "telephone_number": "724-349-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "CISSY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-09",
        "last_updated": "2018-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.