Nicole June Brissette, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

053649 Issued in NY

Practice address

1450 Route 208
Wallkill, NY 12589-3799

Phone

(845) 895-1115

NPI assigned

Nov 21, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment Care Compare group NPD
• Access PT, OT, New York, PLLC

  • Physical Therapist
  • New City, NY
  • NPI 1831539493
  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1134944317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MAYBROOK RD STE L",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 ROUTE 208",
            "city": "WALLKILL",
            "state": "NY",
            "postal_code": "125893799",
            "telephone_number": "845-895-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISSETTE",
        "first_name": "NICOLE",
        "middle_name": "JUNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Beverson
• Gary Blackburn, RN
• Kara Boivin Miller, LMSW
• Tara Boss, B.A. SP. ED.
• Gloria Breau, LPN
• Hailee Brown
• Morgan B Bush
• Erica Campo
• Marissa Lyann Carmine, PA -C
• Ivette Mari Carrion-Dimarco, MSED CCC-SLP

• Physical Therapist in Wallkill, NY
• Providers in Wallkill, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.