Active NPI
Jessica Renee Bisiak, CLINICIAN
- Counselor
- Pawtucket, RI
National Provider Identifier
1336444512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 242 Dexter Street
Pawtucket, RI 02860-8218 - Phone
- (401) 215-6518
- Fax
- (401) 724-8899
- NPI assigned
- Jan 19, 2011
- Last updated
- Feb 3, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
242 Dexter Street
Pawtucket, RI 02860-8218
Mailing address
9 Industrial Rd
Ste 5
Milford, MA 01757-3736
Phone (508) 473-1480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH57134 | Other | RI | MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1336444512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 INDUSTRIAL RD",
"address_2": "STE 5",
"city": "MILFORD",
"state": "MA",
"postal_code": "017573736",
"telephone_number": "508-473-1480",
"fax_number": "508-473-1210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 DEXTER STREET",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028608218",
"telephone_number": "401-215-6518",
"fax_number": "401-724-8899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISIAK",
"first_name": "JESSICA",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "CLINICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-19",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "GH57134",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
- Lalita Bhattacharya, DMD
- BHG Lvii, LLC (BHG Pawtucket Treatment Center)
- BHG Lxxix, LLC (BHG Medical Services - Rhode Island)
- Caitlin Anne Bilodeau, PHARMD
- Kerrie Birchell, MASTERS
- Suzanne Black, MS, MSW
- Blackstone Academny Charter School
- Blackstone Academy Charter School
- Blackstone Cardiology Associates
- Blackstone Cardiology Associates, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.