Individual provider Active NPI

John A Brisson, PA

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1851983886
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PABP.BG.61267147 Issued in WA
Practice address
1460 N 16TH Ave Ste D
Yakima, WA 98902-7102
Phone
(509) 574-3805
Fax
(509) 576-7620
NPI assigned
Feb 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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 PA9114002 FL
Physician Assistant 363A00000X PABP.BG.61267147 WA Primary

Addresses

Primary practice location

1460 N 16TH Ave Ste D
Yakima, WA 98902-7102

Mailing address

1460 N 16TH Ave Ste D
Yakima, WA 98902-7102
Phone (509) 574-3805

Other practice location 1

4901 Market Place Rd
Pensacola, FL 32504-8986
Phone (850) 484-4080

Other practice location 2

855 Downtowner Blvd
Mobile, AL 36609-5403
Phone (850) 484-4080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220328001432 WA Practitioner - Physician Assistant 7719395243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

1460 N 16TH Ave
Suite D
Yakima, WA 98902-7102
Phone (509) 574-3805

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9114002FLMDPhysician Assistant
PABP.BG.61267147WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Feb 25, 2022 Accepting new patients
Yakima Valley Memorial Physicians Past Accepting new patients

Locations

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

1460 N 16th Ave
Ste D
Yakima, WA 98902
Phone (509) 574-3805

Organizations & group practices 2

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 2

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1851983886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE STE D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-574-3805",
            "fax_number": "509-576-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE STE D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-574-3805",
            "fax_number": "509-576-7620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Market Place Rd",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048986",
            "country_code": "US",
            "telephone_number": "850-484-4080",
            "fax_number": "850-484-8801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 Downtowner Blvd",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366095403",
            "country_code": "US",
            "telephone_number": "850-484-4080",
            "fax_number": "850-484-8801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISSON",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114002",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PABP.BG.61267147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.