NPIMap

Individual provider Active NPI

Alyssa M Pearl, PA-C

  • Surgical Physician Assistant
  • Lebanon, NH
National Provider Identifier
1780608612
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0556 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 653-6113
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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 0556 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

4 Church St
Woodstock, VT 05091-1215

Other identifiers 1

IdentifierTypeStateIssuer
30333745MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050830000048 NH Practitioner - Physician Assistant 9032102116 Reassigns benefits to 5 organizations
I20160714001482 VT Practitioner - Physician Assistant 9032102116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Peck Day Memorial HospitalGroup PAC ID 6103737531, shared by 3 NPIs, 132 clinicians

Practice addresses (Care Compare)

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

5 Alice Peck Day Dr
Lebanon, NH 03766-2901
Phone (603) 448-3122

Hospital & facility affiliations

  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305
  • Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital CurrentSince Sep 16, 2012 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Sep 16, 2012 Accepting new patients
The New London Hospital Association, Inc. CurrentSince Jun 19, 2011 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Jan 4, 2026 Accepting new patients
Gifford Medical Center Inc. CurrentSince May 8, 2016 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
The New London Hospital Association, Inc. Past Accepting new patients

Locations

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

106 Hanover St
Lebanon, NH 03766
Phone (603) 448-0447

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

273 County Rd
New London, NH 03257
Phone (603) 526-5215

44 S Main St
Randolph, VT 05060
Phone (802) 728-4441

Interoperability endpoints

  • Direct secure messaging: apearl353913@direct.dartmouth-hitchcock.org
  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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 7

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1780608612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CHURCH ST",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "050911215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARL",
        "first_name": "ALYSSA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30333745",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.