Individual provider Active NPI

Alissa Kuizinas, DPM

  • Podiatrist
  • Concord, MA
National Provider Identifier
1558743880
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2474 Issued in MA
Practice address
54 Baker Avenue Ext Ste 301
Concord, MA 01742-2139
Phone
(978) 369-5282
Fax
(978) 369-2926
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2474 MA Primary

Addresses

Primary practice location

54 Baker Avenue Ext Ste 301
Concord, MA 01742-2139

Mailing address

31 East Rd
Westminster, MA 01473-1669
Phone (978) 424-5527

Other practice location 1

308 Willow Ave
Hoboken, NJ 07030-3808
Phone (978) 424-5527

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181119002611 MA Practitioner - Podiatry 4284988718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2474MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra M Weakland DPM,PC Podiatrist CurrentSince Sep 22, 2018 Accepting new patients

Locations

54 Baker Avenue Ext
Ste 301
Concord, MA 01742
Phone (978) 369-4468

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.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1558743880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 EAST RD",
            "city": "WESTMINSTER",
            "state": "MA",
            "postal_code": "014731669",
            "telephone_number": "978-424-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 BAKER AVENUE EXT STE 301",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422139",
            "telephone_number": "978-369-5282",
            "fax_number": "978-369-2926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Willow Ave",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070303808",
            "country_code": "US",
            "telephone_number": "978-424-5527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUIZINAS",
        "first_name": "ALISSA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "2474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.