Active NPI
Ian Cissel
- Physician Assistant
- Lowell, MA
National Provider Identifier
1356025159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 295 Varnum Ave
Lowell, MA 01854-2134 - Phone
- (978) 937-6000
- NPI assigned
- Jun 12, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
295 Varnum Ave
Lowell, MA 01854-2134
Mailing address
200 Woodview Way Apt 2306
Andover, MA 01810-4592
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- icissel27086@tuftsmedicine.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Lowell, MA
- NPI 1821280959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1356025159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WOODVIEW WAY APT 2306",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018104592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 VARNUM AVE",
"city": "LOWELL",
"state": "MA",
"postal_code": "018542134",
"telephone_number": "978-937-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CISSEL",
"first_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-12",
"last_updated": "2023-06-12",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.