Individual provider Active NPI

Jarryd Rossignol, DO

  • Family Medicine Physician
  • Presque Isle, ME
National Provider Identifier
1063867489
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2904 Issued in ME
Practice address
66 Spruce St Ste 4
Presque Isle, ME 04769-3241
Phone
(207) 769-2025
Fax
(207) 764-0629
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MED-RES.LIC 52134 MT
Family Medicine Physician 207Q00000X DO2904 ME Primary

Addresses

Primary practice location

66 Spruce St Ste 4
Presque Isle, ME 04769-3241

Mailing address

PO Box 40
Caribou, ME 04736-0040
Phone (207) 498-1124

Other practice location 1

123 S 27th St
Billings, MT 59101-4227
Phone (406) 247-3330

Other practice location 2

11 Harmony Ln
Fort Fairfield, ME 04742-3354
Phone (207) 472-0590

Other identifiers 1

IdentifierTypeStateIssuer
14482470OtherCAQH PROVIDER NO.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20190626003044 ME Practitioner - Family Practice 2961795240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pines Health ServicesGroup PAC ID 0749275113, 58 clinicians

Practice addresses (Care Compare)

163 Van Buren Rd
Caribou, ME 04736-3567
Phone (207) 498-6921

74 Access Hwy
Caribou, ME 04736-3807
Phone (207) 498-2350

PO Box
Suite 40
Caribou, ME 04736

Hospital & facility affiliations

  • Northern Light Home Care & Hospice Home health agency, So Portland, ME, CCN 207020
  • Valley Home Health Services Home health agency, Caribou, ME, CCN 207054
  • Northern Light Home Care & Hospice Hospice, South Portland, ME, CCN 201502
  • Cary Medical Center Hospital, Caribou, ME, CCN 200031
  • Northern Light a R Gould Hospital Hospital, Presque Isle, ME, CCN 200018
  • Houlton Regional Hospital Hospital, Houlton, ME, CCN 201308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-RES.LIC 52134MTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
City of Caribou CurrentSince May 19, 2020 Accepting new patients
Pines Health Services Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Pines Health Services Family Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

74 Access Hwy
Caribou, ME 04736
Phone (207) 498-2350

163 Van Buren Rd
Caribou, ME 04736
Phone (207) 498-1320

163 Van Buren Rd
Ste 1
Caribou, ME 04736
Phone (207) 498-1227

11 Harmony Ln
Fort Fairfield, ME 04742
Phone (207) 472-0590

66 Spruce St
Ste 4
Presque Isle, ME 04769
Phone (207) 769-2025

Interoperability endpoints

  • Direct secure messaging: jrossignol376983@direct.ochin.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063867489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047360040",
            "telephone_number": "207-498-1124",
            "fax_number": "207-493-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SPRUCE ST STE 4",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693241",
            "telephone_number": "207-769-2025",
            "fax_number": "207-764-0629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 S 27th St",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591014227",
            "country_code": "US",
            "telephone_number": "406-247-3330",
            "fax_number": "406-247-3389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Harmony Ln",
            "address_purpose": "LOCATION",
            "city": "Fort Fairfield",
            "state": "ME",
            "postal_code": "047423354",
            "country_code": "US",
            "telephone_number": "207-472-0590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSSIGNOL",
        "first_name": "JARRYD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MT",
            "license": "MED-RES.LIC 52134",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NO.",
            "identifier": "14482470",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

Verify at the official NPI Registry.