John James Bisaccia, DC
Individual provider Active NPI Chiropractor · Williston, VT
NPI 1295811024 · NPPES record last updated Dec 3, 2010
Key facts
- NPI
- 1295811024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 006000986 (VT)
- Practice address
- 802 Industrial Ave
Williston, VT 05495 - Phone
- (802) 863-2272
- Fax
- (802) 658-0823
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bisaccia Chiropractors PC
Practice addresses (Care Compare)
802 Industrial Ave
Williston, VT 05495-7122
Phone (802) 863-2272
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060421000009 | VT | Practitioner - Chiropractic | 5991715880 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006000986 | VT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bisaccia Chiropractors PC | Chiropractor | Current |
Accepting new patients |
Locations
802 Industrial Ave
Williston, VT 05495
Phone (802) 863-2272
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 006000986 | VT | Yes |
Addresses
Primary practice location
802 Industrial Ave
Williston, VT 05495
Mailing address
PO Box 669
802 Industrial Ave
Williston, VT 05495
Phone (802) 863-2272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015151 | Medicaid | VT | |
| 29174 | Other | VT | BCBS |
| P00089364 | Other | VT | MEDICARE RAILROAD PIN# |
Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.