RUSSELL WILLIAM BISESI, APRN BC — NPI 1801906797 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent in WALPOLE, MA)

CMS-1500 Box 24J / 33a • NPI

1801906797

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

364SP0807X (CMS 89)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent

Box 32 Service Location & ZIP+4

420 MAIN ST, BOSTON HEALTH CARE, WALPOLE, MA, 02081-3753

✓ 9-Digit EDI 837 ZIP+4 (02081-3753)

Practice Phone & Referral Fax

(508) 660-7949

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1801906797 (RUSSELL WILLIAM BISESI, APRN BC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1801906797` (NPI-1 Individual Practitioner)
Provider / Legal Name	RUSSELL WILLIAM BISESI, APRN BC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent NUCC Code: `364SP0807X` (Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	420 MAIN ST, BOSTON HEALTH CARE, WALPOLE, MA, 02081-3753
Practice Telephone / Fax	Tel: (508) 660-7949
Administrative Mailing Address	136 WELD ST, ROSLINDALE, MA, 02131-1042
Enumeration & Last Sync	Enumerated: 2006-08-30 \| CMS Record Updated: 2016-03-21

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

420 MAIN ST, BOSTON HEALTH CARE, WALPOLE, MA, 02081-3753

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Plain-English Taxonomy & CMS Crosswalk (364SP0807X)

What Does Taxonomy Code 364SP0807X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SP0807X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 89 (Certified Clinical Nurse Specialist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (RUSSELL WILLIAM BISESI, APRN BC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`364SP0807X` — Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent	State: MA \| License: `242633` \| Primary: Yes (Primary)
`364SP0808X` — Clinical Nurse Specialist, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health	State: MA \| License: `242633` \| Primary: Secondary

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RUSSELL WILLIAM BISESI, APRN BC (NPI #1801906797)