Individual provider Active NPI

Breanne Elizabeth Bisset, NP

  • Gerontology Nurse Practitioner
  • Ellsworth, ME
National Provider Identifier
1104502012
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
CNP231340 Issued in ME
Practice address
32 Resort Way
Ellsworth, ME 04605
Phone
(207) 664-7800
NPI assigned
Jun 26, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X CNP231340 ME Primary

Addresses

Primary practice location

32 Resort Way
Ellsworth, ME 04605

Mailing address

32 Resort Way
Ellsworth, ME 04605

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731000195 ME Practitioner - Nurse Practitioner 7315308939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

32 Resort Way
Ellsworth, ME 04605-1717

50 Union St
Ellsworth, ME 04605-1534

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Blue Hill Memorial Hospital CurrentSince Jul 9, 2023 Accepting new patients
The Blue Hill Memorial Hospital CurrentSince Jul 9, 2023 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Jul 9, 2023 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Jul 9, 2023 Accepting new patients

Locations

57 Water St
Blue Hill, ME 04614
Phone (207) 374-3400

43 Whiting Hill Rd
Ste 200
Brewer, ME 04412
Phone (800) 757-3326

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

32 Resort Way
Ellsworth, ME 04605
Phone (207) 664-5480

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

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": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1104502012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 RESORT WAY",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "04605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 RESORT WAY",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "04605",
            "telephone_number": "207-664-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSET",
        "first_name": "BREANNE",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ME",
            "license": "CNP231340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

Verify at the official NPI Registry.