Individual provider Active NPI

Samantha Sisskind, ACNPC-AG

  • Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1053883322
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2312356 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-0001
Phone
(781) 744-8000
NPI assigned
Dec 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2312356 MA
Nurse Practitioner 363L00000X RN2312356 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-0001

Mailing address

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8000

Other names 1

  • Samantha Weinstein Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190813002312 MA Practitioner - Nurse Practitioner 8123355146 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2312356MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Lahey Clinic, Inc Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Dana-Farber Cancer Institute, Inc. Current Accepting new patients
Lahey Clinic, Inc. CurrentSince Sep 22, 2020 Accepting new patients
Life Choice Hospice of Southern Massachusetts LLC CurrentSince Feb 11, 2021 Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

790 Turnpike St
Ste 202
North Andover, MA 01845
Phone (978) 777-8222

101 Columbian St
Weymouth, MA 02190
Phone (781) 624-4800

101 Columbian St
Fl 3
Weymouth, MA 02190
Phone (781) 624-4800

Interoperability endpoints

  • Direct secure messaging: sisskind.samantha.dfci@direct.partners.masshiway.net

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1053883322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSKIND",
        "first_name": "SAMANTHA",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2312356",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2312356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "WEINSTEIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.