MS. SUSAN LYNNE DEBALSI (NPI# 1649318288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649318288 |
| Entity Type | Individual |
| Full Name | MS. SUSAN LYNNE DEBALSI |
| Credential | PA-C |
| Practice Address |
200 Mill Road Suite 190 Fairhaven MA 02719 |
| Mailing Address |
200 Mill Rd Suite 180 Fairhaven MA 02719-5252 |
| Practice Telephone | 5089732160 |
| Practice Fax Number | 5089732176 |
| Mailing Telephone | 5089733000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2013-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1212 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00663 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
1212 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 MILL ROAD SUITE 190 |
| City | FAIRHAVEN |
| State | MA |
| Zip Code | 02719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336137629 | Southcoast Physicians Group, Inc. | Internal Medicine | 200 Mill Road, Suite 180, Fairhaven, MA 02719-5252 | 2005-10-11 |
| 1861808453 | Ashley C Paiva | Nurse Practitioner | 200 Mill Road, Suite 190, Fairhaven, MA 02719-5255 | 2014-07-03 |
| 1558794651 | Kimberly Ann Moniz | Nurse Practitioner | 200 Mill Road, Suite 180, Fairhaven, MA 02719 | 2013-08-13 |
| 1861411449 | Susan Wareing | Nurse Practitioner | 200 Mill Road, Suite 180, Fairhaven, MA 02719 | 2006-07-18 |
| 1477522290 | Chandra S Reddivari | Internal Medicine | 200 Mill Road, Suite 190, Fairhaven, MA 02719-5252 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457589772 | David Paul Patterson | Nurse Practitioner | 271 Alden Rd, Fairhaven, MA 02719 | 2009-06-25 |
| 1245415983 | Carol Ann Reeve | Social Worker | 21 Nelson Ave, Fairhaven, MA 02719 | 2007-12-31 |
| 1194842716 | Cathleen Lacy | Physical Therapist | 333 Bridge St, Fairhaven, MA 02719 | 2007-03-26 |
| 1700903978 | Barbara Ann Acksen | Psychologist | 91 Green Street, Fairhaven, MA 02719 | 2007-03-23 |
| 1811023260 | Merolla Chiropractic Inc | Chiropractor | 73 Alden Rd, Fairhaven, MA 02719 | 2007-02-27 |
| 1982746442 | Michele E Merolla | Chiropractor | 73 Aiden Rd, Fairhaven, MA 02719 | 2007-02-13 |
| 1417016338 | Brian K Bowcock | Chiropractor | 84 Huttleston Avenue, Fairhaven, MA 02719 | 2006-12-06 |
| 1104937697 | Southcoast Visiting Nurse Association. Inc | Home Health | 200 Mill Road, Suite 120, Fairhaven, MA 02719 | 2006-08-31 |
| 1902817299 | 184 Main LLC | Skilled Nursing Facility | 184 Main Street, Fairhaven, MA 02719 | 2006-08-11 |
| 1821584103 | Smiley Dental Care Pllc | Clinic/Center | 17 Berdon Way, Fairheaven, MA 02719 | 2018-07-10 |
| Find all providers in zip 02719 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053863126 | Sandra Hornig | Physician Assistant | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2016-10-25 |
| 1154471464 | David Edward Taylor | Physician Assistant | 208 Mill Road, Fairhaven, MA 02719-5252 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897024 | Eoin Moriarty | Physician Assistant | 99 Merryknoll Rd, Weymouth, MA 02191-2020 | 2020-09-30 |
| 1942812334 | Manacey Clermont | Physician Assistant | 21 Robinson Rd, Woburn, MA 01801-6136 | 2020-08-18 |
| 1801411756 | Kimberly Marques | Physician Assistant | 3 Medeiros Farm Rd, Seekonk, MA 02771-2029 | 2020-06-16 |
| 1821613548 | Emily Reynolds | Physician Assistant | 7 Blood Rd, Charlton, MA 01507-5128 | 2020-06-09 |
| 1275155590 | Makenna Camara | Physician Assistant | 249 Hixville Rd, North Dartmouth, MA 02747-1937 | 2020-05-08 |
| 1720608912 | John Eastman | Physician Assistant | 243b Savin Hill Ave, Boston, MA 02125-1003 | 2020-04-17 |
| 1871122168 | Alexandra Emmanuelle Rochman | Physician Assistant | 54 W Crystal Brook Dr, Springfield, MA 01118-1946 | 2020-04-07 |
| 1366074122 | Heather Kirby | Physician Assistant | 264 Fowler Rd, Westfield, MA 01085-4013 | 2020-02-10 |
| 1639712011 | Joseph John Milos | Physician Assistant | 201 Carlson Ln, West Barnstable, MA 02668-1224 | 2019-10-18 |
| 1912558321 | Rafael Rondeau | Physician Assistant | 12 Indian Pond Rd, Kingston, MA 02364-2051 | 2019-09-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.