Patty Rissacher, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

266529 Issued in NY

Practice address

80 E Main St
Canton, NY 13617-1450

Phone

(315) 261-7180

Fax

(315) 261-7183

NPI assigned

Mar 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Patty Waterhouse Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatric Medicine, PLC

  • Pediatrics Physician
  • South Burlington, VT
  • NPI 1487701140
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1942333745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 E MAIN ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E MAIN ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171450",
            "telephone_number": "315-261-7180",
            "fax_number": "315-261-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSACHER",
        "first_name": "PATTY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "042-0011547",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "266529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015060",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATTY",
            "last_name": "WATERHOUSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sabrina Reed
• Kim M. Richards, NPP & FNP
• Amy Lynn Richardson, L.M.H.C.
• Claire Richardson, OTRL
• Susan Riley
• Rite Aid of New York Inc
• Brandi L Romano, RPH
• Jessica Lynn Rose
• Tamara Louise Rosemyer
• Curt D Ross, DDS

• Pediatrics Physician in Canton, NY
• Providers in Canton, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.