Alexander Kisselgof, LIC. AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

672 Issued in MA

Practice address

20 Elm Street
Vineyard Haven, MA 02568-0933

Phone

(508) 693-3060

NPI assigned

Jun 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356545735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4351",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025680933",
            "telephone_number": "508-693-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ELM STREET",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025680933",
            "telephone_number": "508-693-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELGOF",
        "first_name": "ALEXANDER",
        "credential": "LIC. AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MA",
            "license": "672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saundra Hart Johnson, MA
• Catherine Keller, LCSW
• Patricia Marie Keohane, LMHC
• Carolyn Jane Kildegaard, MA
• Lydia Catherine Kingsbury
• April Knight, M.A., LMHC
• Kathleen E Koehler, MD
• Fae E Kontje-Gibbs, LIC. AC.
• Kristine Kopp, D.C.
• Terry F Kriedman, M.D.

• Acupuncturist in Vineyard Haven, MA
• Providers in Vineyard Haven, MA by specialty
• Acupuncturist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.