Active NPI
Lynne A Bisbano, PA-C
- Physician Assistant
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00080
- Practice address
- 345 Blackstone Blvd
Providence, RI 02906-4800 - Phone
- (401) 455-6200
- Fax
- (401) 455-6689
- NPI assigned
- Jun 2, 2005
- Last updated
- Oct 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00080 | RI | Primary |
| Physician Assistant | 363A00000X | PA245 | MA |
Addresses
Primary practice location
345 Blackstone Blvd
Providence, RI 02906-4800
Mailing address
345 Blackstone Blvd
Providence, RI 02906-4829
Phone (401) 455-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010
455 Tollgate Rd
Warwick, RI 02886-2759
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 245 | MA | MD | Marriage & Family Therapist |
| PA245 | MA | MD | Physician Assistant |
| PA00080 | RI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhode Island Hospital | Current | Accepting new patients | |
| Affinity Physicians LLC. | Current | Accepting new patients | |
| Rhode Island Hospital | Current | Accepting new patients | |
| Coastal Medical, Inc. | Past | Accepting new patients | |
| MW Wellness Ventures IV LLC | Past | Accepting new patients | |
| Southcoast Physicians Group, Inc. | Past | Accepting new patients | |
| Coastal Medical Inc | Past | Accepting new patients |
Locations
1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000
345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375
593 Eddy St
Providence, RI 02903
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Warwick, RI
- NPI 1184944662
-
- Multi-Specialty Clinic/Center
- Providence, RI
- NPI 1154537520
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- Internal Medicine Physician
- Providence, RI
- NPI 1609863828
-
- Non-Pharmacy Dispensing Site
- Cranston, RI
- NPI 1184767022
-
- Family Medicine Physician
- Dartmouth, MA
- NPI 1194308494
-
- Family Medicine Physician
- Fairhaven, MA
- NPI 1336137629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1245234517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064829",
"telephone_number": "401-455-6200",
"fax_number": "401-455-6689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6200",
"fax_number": "401-455-6689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISBANO",
"first_name": "LYNNE",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-02",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "RI",
"license": "PA00080",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA245",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.