Individual provider Active NPI

Julie Marie Sisson, P.A.

  • Physician Assistant
  • Manchester, NH
National Provider Identifier
1114209145
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0946 Issued in NH
Practice address
100 Hitchcock Way
Manchester, NH 03104-4125
Phone
(603) 695-2500
NPI assigned
Sep 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA4247 MA
Physician Assistant 363A00000X PA001305 ME
Physician Assistant 363A00000X 0946 NH Primary

Addresses

Primary practice location

100 Hitchcock Way
Manchester, NH 03104-4125

Mailing address

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

Other practice location 1

6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Phone (603) 537-1300

Other identifiers 1

IdentifierTypeStateIssuer
3110994MedicaidNH

Other names 1

  • Ms. Julie Thompson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20171229000889 NH Practitioner - Physician Assistant 8325271216 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Clearchoicemd, PLLCGroup PAC ID 1850510058, 85 clinicians

Practice addresses (Care Compare)

127 Plaistow Rd
Suite 1
Plaistow, NH 03865-2811
Phone (603) 797-9289

410 Miracle Mile
Lebanon, NH 03766-2639
Phone (603) 276-3260

636 Lafayette Rd
Seabrook, NH 03874-4298
Phone (603) 457-7830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA4247MAMDPhysician Assistant
PA001305MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clearchoicemd, PLLC CurrentSince Nov 12, 2021 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Dec 4, 2017 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Dec 4, 2017 Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

410 Miracle Mile
Lebanon, NH 03766
Phone (603) 276-3260

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

Organizations & group practices 5

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": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1114209145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-695-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-695-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Tsienneto Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381584",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISSON",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4247",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001305",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3110994",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "THOMPSON",
            "prefix": "MS.",
            "credential": "P.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.