Individual provider Active NPI

Madeline Bissaillon

  • Physical Therapist
  • East Hampstead, NH
National Provider Identifier
1194190348
Registry record updated Dec 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4029 Issued in NH
Practice address
45 Danville Rd
East Hampstead, NH 03826-2451
Phone
(603) 382-0019
NPI assigned
Dec 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4029 NH Primary

Addresses

Primary practice location

45 Danville Rd
East Hampstead, NH 03826-2451

Mailing address

18 Summer St
Merrimac, MA 01860-1432
Phone (603) 557-9680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180713001055 NH Practitioner - Physical Therapist in Private Practice 2961758420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derry Sports and Rehab LLCGroup PAC ID 1052666807, 6 clinicians

Practice addresses (Care Compare)

45 Danville Rd
East Hampstead, NH 03826-2451
Phone (603) 382-0019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Derry Sports & Rehab, LLC Physical Therapist CurrentSince Jun 1, 2018 Accepting new patients
Derry Sports & Rehab, LLC Physical Therapist CurrentSince Jun 1, 2018 Accepting new patients

Locations

23 Crystal Ave
Unit 2A
Derry, NH 03038
Phone (603) 437-3338

45 Danville Rd
East Hampstead, NH 03826
Phone (603) 382-0019

700 Lake Ave
Ste 2
Manchester, NH 03103
Phone (603) 621-0681

55 Bridge St
Manchester, NH 03101

159 N Broadway
Ste 2A
Salem, NH 03079
Phone (603) 644-5900

Organizations & group practices 2

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": "1449964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449964800000",
    "number": "1194190348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SUMMER ST",
            "city": "MERRIMAC",
            "state": "MA",
            "postal_code": "018601432",
            "telephone_number": "603-557-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DANVILLE RD",
            "city": "EAST HAMPSTEAD",
            "state": "NH",
            "postal_code": "038262451",
            "telephone_number": "603-382-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSAILLON",
        "first_name": "MADELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-13",
        "last_updated": "2015-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hampstead, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2015; 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.