Individual provider Active NPI

Jisselle Assad, APRN, FNP, PMHNP

  • Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1679145452
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2295861 Issued in MA
Practice address
645 Belmont Ave
Springfield, MA 01108-2440
Phone
(413) 435-0759
Fax
(773) 492-8735
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2295861 MA Primary

Addresses

Primary practice location

645 Belmont Ave
Springfield, MA 01108-2440

Mailing address

645 Belmont Ave
Springfield, MA 01108-2440
Phone (413) 435-0759

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
I20221215000501 MA Practitioner - Nurse Practitioner 3274902119 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center at Millbury LLC CurrentSince Jan 1, 2025 Accepting new patients
Stepping Stones Psychiatry, LLC CurrentSince Sep 1, 2025 Accepting new patients
Holyoke Health Center Inc. Past Accepting new patients
Orenda Psychiatry PLLC Past Accepting new patients

Locations

2328 10th Ave N
Ste 302
Lake Worth Beach, FL 33461
Phone (561) 318-4411

29 Main St
Ste 100
Millbury, MA 01527
Phone (508) 433-3866

29 Main St
Ste 300
Millbury, MA 01527
Phone (508) 475-5676

201 Park Ave
Ste 5
West Springfield, MA 01089
Phone (413) 300-3999

Organizations & group practices 5

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1679145452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BELMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011082440",
            "telephone_number": "413-435-0759",
            "fax_number": "773-492-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BELMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011082440",
            "telephone_number": "413-435-0759",
            "fax_number": "773-492-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSAD",
        "first_name": "JISSELLE",
        "credential": "APRN, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2295861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.