Individual provider Active NPI

Robin Lee Bissell, M.D.

  • General Practice Physician
  • Grantsville, MD
National Provider Identifier
1033117221
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D0034231 Issued in MD
Practice address
124 Miller St
Grantsville, MD 21536-1383
Phone
(240) 444-4219
Fax
(475) 277-4961
NPI assigned
Jul 12, 2005
Last updated
Sep 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X D0034231 MD Primary

Addresses

Primary practice location

124 Miller St
Grantsville, MD 21536-1383

Mailing address

PO Box 718
Grantsville, MD 21536-0718
Phone (240) 444-4219

Other identifiers 7

IdentifierTypeStateIssuer
287151300MedicaidMA
521686633OtherCOMMERCIAL
P13867OtherMDBCBS
71816401OtherMDBS
287151300MedicaidMD
R1990001OtherMDBLUE CHOICE
865494OtherUNITED HEALTH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061113000115 MD Practitioner - General Practice 5991703688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodwill Mennonite Home, Inc.Group PAC ID 1759376866, 6 clinicians

Practice addresses (Care Compare)

891 Dorsey Hotel Rd
Grantsville, MD 21536-1369
Phone 3018955194201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Goodwill Mennonite Home, Inc. CurrentSince Dec 1, 2019 Accepting new patients
Northern Garrett County Rescue Squad, Inc. PastSince Jul 1, 2006 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

891 Dorsey Hotel Rd
Grantsville, MD 21536
Phone (301) 895-5194

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1033117221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 718",
            "city": "GRANTSVILLE",
            "state": "MD",
            "postal_code": "215360718",
            "telephone_number": "240-444-4219",
            "fax_number": "475-277-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MILLER ST",
            "city": "GRANTSVILLE",
            "state": "MD",
            "postal_code": "215361383",
            "telephone_number": "240-444-4219",
            "fax_number": "475-277-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSELL",
        "first_name": "ROBIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0034231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287151300",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "521686633",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P13867",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "71816401",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287151300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "R1990001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "865494",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsville, MD

Sources for this page

Verify at the official NPI Registry.