Organization Active NPI

New England Tissue Issue, PLLC

  • Clinical Medical Laboratory
  • Fall River, MA
National Provider Identifier
1255649828
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NEW ENGLAND TISSUE ISSUE, PLLC
Practice address
1822 N Main St
Suite 302
Fall River, MA 02720-1318
Phone
(401) 523-7512
NPI assigned
Sep 16, 2010
Last updated
Sep 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Mrs. Ilsa Marie Ramirez, MBA, MHSM
Title
Compliance Specialist
Phone
(469) 532-0667

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary
Dermatopathology Physician 207ND0900X NU
Dermatopathology (Pathology) Physician 207ZD0900X NU

Addresses

Primary practice location

1822 N Main St
Suite 302
Fall River, MA 02720-1318

Mailing address

1822 N Main St
Suite 302
Fall River, MA 02720-1318

Other identifiers 1

IdentifierTypeStateIssuer
LCO00672OtherRISTATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH

Other names 1

  • New England Tissue Issue, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110512000573 MA Part B Supplier - Independent Clinical Laboratory 8022294875 Practice locations: Fall River, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2015045New England Tissue Issue Inc1822 North Main Street, Fall River, MA 02720AccreditationJul 23, 2027

National Provider Directory

National Provider Directory

Locations

1822 N Main St
Ste 302
Fall River, MA 02720
Phone (401) 683-8964

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1255649828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 N MAIN ST",
            "address_2": "SUITE 302",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 N MAIN ST",
            "address_2": "SUITE 302",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201318",
            "telephone_number": "401-523-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ENGLAND TISSUE ISSUE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "ILSA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "COMPLIANCE SPECIALIST",
        "authorized_official_telephone_number": "469-532-0667",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA, MHSM"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH",
            "identifier": "LCO00672",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New England Tissue Issue, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.