Individual provider Active NPI

Alyssa Elena Rebussini, PA-C

  • Physician Assistant
  • Johnston, RI
National Provider Identifier
1740914704
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01495 Issued in RI
Practice address
1524 Atwood Ave Ste 140
Johnston, RI 02919-3288
Phone
(401) 457-1500
NPI assigned
Jul 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA8827 MA
Physician Assistant 363A00000X PA01495 RI Primary

Addresses

Primary practice location

1524 Atwood Ave Ste 140
Johnston, RI 02919-3288

Mailing address

PO Box 1119
Providence, RI 02901-1119

Other names 1

  • Alyssa Elena Lamond Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221117001451 MA Practitioner - Physician Assistant 6709254014 Reassigns benefits to 1 organization
I20230419001091 RI Practitioner - Physician Assistant 6709254014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01495RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics, Inc. CurrentSince Mar 13, 2023 Accepting new patients
University Orthopedics, Inc. CurrentSince Mar 13, 2023 Accepting new patients

Locations

1524 Atwood Ave
Ste 140
Johnston, RI 02919
Phone (401) 351-6200

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

Interoperability endpoints

  • Direct secure messaging: alyssa.lamond@10362.chartlogic.direct-ci.com
  • Direct secure messaging: alyssa.lamond.1@13709.direct.athenahealth.com

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1740914704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 ATWOOD AVE STE 140",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193288",
            "telephone_number": "401-457-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBUSSINI",
        "first_name": "ALYSSA",
        "middle_name": "ELENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8827",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "LAMOND",
            "middle_name": "ELENA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.