Jill Renee Dusseault, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2350 Issued in ME

Practice address

22 Bramhall St
Portland, ME 04102-3175

Phone

(207) 662-2413

NPI assigned

Oct 9, 2017

Last updated

Jun 28, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MA

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046
• Fairview Hospital Hospital, Great Barrington, MA, CCN 221302
• North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jilldusseault@bfs.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Berkshire Faculty Services Inc

  • Multi-Specialty Clinic/Center
  • Pittsfield, MA
  • NPI 1548212939
  Medicare reassignment Care Compare group
• Fairview Hospital

  dba East Mountain Medical

  • Rural Health Clinic/Center
  • Great Barrington, MA
  • NPI 1881252286
  NPD

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

• Berkshire Medical Center, Inc

  • General Acute Care Hospital
  • Pittsfield, MA
  • NPI 1295765261
  Care Compare affiliation
• Fairview Hospital

  • Critical Access Hospital
  • Great Barrington, MA
  • NPI 1730112251
  Care Compare affiliation
• North Adams Regional Hospital Corporation

  • Critical Access Hospital
  • North Adams, MA
  • NPI 1437839669
  Care Compare affiliation

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1972013613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175",
            "telephone_number": "207-662-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175",
            "telephone_number": "207-662-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSSEAULT",
        "first_name": "JILL",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2350",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert M Durgin, LCSW
• Rebecca Durgin, LMSW-CC
• Aarone Rae Durocher, ATC, OTC, OT-SC
• Vicki V Durrell, LSW
• Linda S. Durst, MD
• Christa-Marie Dutremble, APRN-NP-C
• Joshua Adam Dwinal, PHARM.D.
• Zephyr D. Dworsky, MD
• Deena Dwyer
• Keara Margaret Dwyer, PMHNP

• Physician Assistant in Portland, ME
• Providers in Portland, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.