Individual provider Active NPI

Alyssa J Mawson

  • Physician Assistant
  • North Grosvenordale, CT
National Provider Identifier
1497564488
Registry record updated Mar 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
415 Riverside Dr
North Grosvenordale, CT 06255-2134
Phone
(860) 923-9511
NPI assigned
Jan 3, 2025
Last updated
Mar 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2026

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 Primary

Addresses

Primary practice location

415 Riverside Dr
North Grosvenordale, CT 06255-2134

Mailing address

415 Riverside Dr
North Grosvenordale, CT 06255-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260407000929 CT Practitioner - Physician Assistant 0749765196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772323200000",
    "number": "1497564488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 RIVERSIDE DR",
            "city": "NORTH GROSVENORDALE",
            "state": "CT",
            "postal_code": "062552134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 RIVERSIDE DR",
            "city": "NORTH GROSVENORDALE",
            "state": "CT",
            "postal_code": "062552134",
            "telephone_number": "860-923-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWSON",
        "first_name": "ALYSSA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2026-03-01",
        "certification_date": "2026-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Grosvenordale, CT

Sources for this page

Verify at the official NPI Registry.