NPIMap

Individual provider Active NPI

Jessica Croteau, PA

  • Physician Assistant
  • Bristol, NH
National Provider Identifier
1356724843
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1107 Issued in NH
Practice address
100 Robie Road
Bristol, NH 03222
Phone
(603) 744-6200
Fax
(603) 536-4001
NPI assigned
Jul 2, 2015
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1107 NH Primary

Addresses

Primary practice location

100 Robie Road
Bristol, NH 03222

Mailing address

100 Robie Rd
Bristol, NH 03222
Phone (603) 744-6200

Other practice location 1

101 Boulder Point Dr Ste 1
Plymouth, NH 03264-3170
Phone (603) 536-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150827001842 NH Practitioner - Physician Assistant 2062728686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-State Health CenterGroup PAC ID 1951363563, 32 clinicians

Practice addresses (Care Compare)

100 Robie Rd
Alexandria, NH 03222-6063
Phone 60374462001004

101 Boulder Point Dr
Plymouth, NH 03264-3170
Phone 60353640001004

28 Main St
Plymouth, NH 03264-1440
Phone (603) 536-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1107NHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Speare Memorial Hospital CurrentSince Jul 13, 2015 Accepting new patients
Speare Memorial Hospital CurrentSince Jul 13, 2015 Accepting new patients
Mid-State Health Center CurrentSince Jan 6, 2022 Accepting new patients
Mid-State Health Center CurrentSince Jan 6, 2022 Accepting new patients
Mid-State Health Center Past Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

100 Robie Rd
Alexandria, NH 03222
Phone (603) 744-6200

101 Boulder Point Dr
Ste 1
Plymouth, NH 03264
Phone (603) 238-3537

16 Hospital Rd
Plymouth, NH 03264
Phone (603) 238-2229

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1356724843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROBIE RD",
            "city": "BRISTOL",
            "state": "NH",
            "postal_code": "03222",
            "telephone_number": "603-744-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROBIE ROAD",
            "city": "BRISTOL",
            "state": "NH",
            "postal_code": "03222",
            "telephone_number": "603-744-6200",
            "fax_number": "603-536-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Boulder Point Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "NH",
            "postal_code": "032643170",
            "country_code": "US",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROTEAU",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, NH

Sources for this page

Verify at the official NPI Registry.