Alyssa J Mawson
Individual provider Active NPI Physician Assistant · North Grosvenordale, CT
NPI 1497564488 · NPPES record last updated Mar 1, 2026
Key facts
- NPI
- 1497564488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 415 Riverside Dr
North Grosvenordale, CT 06255-2134 - Phone
- (860) 923-9511
- NPI assigned
- Jan 3, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
397 Sand Dam Rd
Thompson, CT 06277-1444
415 Riverside Dr
Suite 1
North Grosvenordale, CT 06255-2134
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260407000929 | CT | Practitioner - Physician Assistant | 0749765196 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
415 Riverside Dr
North Grosvenordale, CT 06255-2134
Mailing address
415 Riverside Dr
North Grosvenordale, CT 06255-2134
Other providers in North Grosvenordale, CT
- Kristine Marie Dipasquale
- Beth Ann Flannery Spillane
- Melissa Ann Gobin-Borski
- Christina M Labby
- Jennifer Ann Martell
- Melissa Gobin, Licsw, LCSW LLC
- Outpatient Mobile
- Outpatient Mobile Solutions, Inc.
- Jason Ratto
- Tamah P Senosk
All providers in North Grosvenordale, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.