Individual provider Active NPI

John Charles Rossignol, P.A.-C

  • Physician Assistant
  • Avon, CT
National Provider Identifier
1275976052
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000853 Issued in CT
Practice address
36 E Main St
Avon, CT 06001-3801
Phone
(860) 677-5533
Fax
(860) 678-1305
NPI assigned
Apr 11, 2013
Last updated
Apr 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000853 CT Primary

Addresses

Primary practice location

36 E Main St
Avon, CT 06001-3801

Mailing address

36 E Main St
Avon, CT 06001-3801
Phone (860) 677-5533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160602000315 CT Practitioner - Physician Assistant 8123318243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avon Medical Professionals, LLCGroup PAC ID 8224091384, 3 clinicians

Practice addresses (Care Compare)

36 E Main St
Avon, CT 06001-3801
Phone (860) 677-5533

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000853CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Medical Associates, PA Past Accepting new patients
Eastern Conn. Cardiology Group PastSince Jan 1, 2006 Accepting new patients
Eastern CT Cardiology Diagnostics, LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1275976052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013801",
            "telephone_number": "860-677-5533",
            "fax_number": "860-678-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013801",
            "telephone_number": "860-677-5533",
            "fax_number": "860-678-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSIGNOL",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.