Active NPI
Jessica E Spissinger, PA, LICSW
- Physician Assistant
- Quincy, MA
National Provider Identifier
1356599583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA4763
- Practice address
- 43 Stedman St
Quincy, MA 02169-1220 - Phone
- (773) 240-7492
- NPI assigned
- Aug 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149012972 | IL | |
| Clinical Social Worker | 1041C0700X | 23936 | CA | |
| Physician Assistant | 363A00000X | PA4763 | MA | Primary |
| Clinical Social Worker | 1041C0700X | 117721 | MA |
Addresses
Primary practice location
43 Stedman St
Quincy, MA 02169-1220
Mailing address
43 Stedman St
Quincy, MA 02169-1220
Phone (773) 240-7492
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 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149012972 | IL | MD | Clinical Social Worker |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Walpole, MA
- NPI 1821065640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382659200000",
"number": "1356599583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 STEDMAN ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691220",
"telephone_number": "773-240-7492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 STEDMAN ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691220",
"telephone_number": "773-240-7492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPISSINGER",
"first_name": "JESSICA",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "PA, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-29",
"last_updated": "2013-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149012972",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "23936",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA4763",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "117721",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.