Nino Boissonneault, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60257982 Issued in WA

Practice address

307 S. 13TH Street, Suite 300
Skagit Regional Clinics - Cardiology
Mount Vernon, WA 98274

Phone

(360) 336-9757

Fax

(360) 814-5237

NPI assigned

Apr 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
• Cascade Valley Hospital Hospital, Arlington, WA, CCN 500060

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nboissonneault12099@skagit.direct-ci.com

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.

• Public Hospital Dist No 1 Skagit

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment Care Compare group
• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  Medicare reassignment NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD
• Public Hospital Dist No 1 Skagit

  • Anesthesiology Physician
  • Arlington, WA
  • NPI 1265791065
  NPD
• Public Hospital Dist No 1 Skagit

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Public Hospital Dist No 1 Skagit

  • Specialist
  • Mount Vernon, WA
  • NPI 1629012463
  NPD (past)

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

• Public Hospital Dist No 1 Skagit

  • General Acute Care Hospital
  • Mount Vernon, WA
  • NPI 1053357244
  Care Compare affiliation
• Public Hospital Dist No 1 Skagit

  • General Acute Care Hospital
  • Arlington, WA
  • NPI 1073566246
  Care Compare affiliation

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1881911105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. KINCAID STREET",
            "address_2": "ATTN: CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S. 13TH STREET, SUITE 300",
            "address_2": "SKAGIT REGIONAL CLINICS - CARDIOLOGY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98274",
            "telephone_number": "360-336-9757",
            "fax_number": "360-814-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISSONNEAULT",
        "first_name": "NINO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60257982",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60257982",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60257982",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016681",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwin Blau, MSW
• Lonnie N Bloom, PT
• Alvera Blow, MSW, LSWAIC
• Bodysoulhealing LLC
• Charles Hermann Bogdahn, LCSW
• David Burke Bond, DPT
• John D Bond, MD
• Constance Marlene Bonner-Britt, LMHC
• Pasawat Boon-Yasidhi, MD
• Judith Ann Booth, LMP

• Physician Assistant in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.