Individual provider Active NPI

Nicole Lissandri, PA-C

  • Surgical Physician Assistant
  • Springfield, MA
National Provider Identifier
1548669716
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA5080 Issued in MA
Practice address
271 Carew St
Springfield, MA 01104-2377
Phone
(413) 748-9000
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA5080 MA Primary

Addresses

Primary practice location

271 Carew St
Springfield, MA 01104-2377

Mailing address

8 Christine Dr
West Springfield, MA 01089-2230
Phone (413) 265-1286

Other names 1

  • Nicole Lambert Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150225002480 MA Practitioner - Physician Assistant 1153647771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

233 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Jun 1, 2021 Accepting new patients

Locations

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1548669716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHRISTINE DR",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010892230",
            "telephone_number": "413-265-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 CAREW ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042377",
            "telephone_number": "413-748-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSANDRI",
        "first_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA5080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LAMBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.