Jessica Leeanne Pietersen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01587 Issued in RI

Practice address

36 Bridge Way
Pascoag, RI 02859-3131

Phone

(401) 567-0800

NPI assigned

May 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Community Health CareGroup PAC ID 1355250663, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Miriam Hospital Hospital, Providence, RI, CCN 410012

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northwest Community Health Care

  • Community Health Clinic/Center
  • N. Kingstown, RI
  • NPI 1801951397
  Medicare reassignment Care Compare group
• Northwest Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Foster, RI
  • NPI 1821254525
  NPD
• Northwest Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Pascoag, RI
  • NPI 1245219070
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1811689342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GENTIAN RD",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027661624",
            "telephone_number": "508-838-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 BRIDGE WAY",
            "city": "PASCOAG",
            "state": "RI",
            "postal_code": "028593131",
            "telephone_number": "401-567-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETERSEN",
        "first_name": "JESSICA",
        "middle_name": "LEEANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pascoag Fire District Light Dept
• Muriel Bertha Paterson, LICSW
• Caroline M. Pellegrino, SLP
• Judith Peloquin, OTRL
• Olin Nicholas Perkins, PA-C
• Stephanie Pinto, NP
• Prominent Medical Supplies
• Kaja Puerini, DMD
• Nancy Jean Quintiliani, PT
• Maryam Rayani, DMD

• Physician Assistant in Pascoag, RI
• Providers in Pascoag, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.