Individual provider Active NPI

Stephanie Kennedy Bisson, PA

  • Physician Assistant
  • Troy, NY
National Provider Identifier
1629363585
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
P80184 Issued in NY
Practice address
2215 Burdett Ave
Troy, NY 12180-2466
Phone
(518) 271-3450
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 P80184 NY Primary

Addresses

Primary practice location

2215 Burdett Ave
Troy, NY 12180-2466

Mailing address

22 Tryon St
Albany, NY 12203-3246
Phone (518) 478-4884

Other practice location 1

1300 Massachusetts Ave
Troy, NY 12180-1628
Phone (518) 268-5234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110715000122 NY Practitioner - Physician Assistant 5799953881 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P80184NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Physician Assistant CurrentSince Jan 1, 2019 Accepting new patients
Samaritan Hospital of Troy, New York Physician Assistant CurrentSince Jan 1, 2019 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

2 Empire Dr
Ste 202
Rensselaer, NY 12144
Phone (518) 286-4990

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

Interoperability endpoints

  • Direct secure messaging: sbisson788119@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629363585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TRYON ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033246",
            "telephone_number": "518-478-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802466",
            "telephone_number": "518-271-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISSON",
        "first_name": "STEPHANIE",
        "middle_name": "KENNEDY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "P80184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.