Jessica Lise Vercruysse, MD - Medicare Emergency Medicine in Willimantic, CT

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Jessica Lise Vercruysse, MD is a medicare enrolled "Emergency Medicine" physician in Willimantic, Connecticut. Her current practice location is 112 Mansfield Ave, Willimantic, Connecticut. You can reach out to her office (for appointments etc.) via phone at (904) 265-6850.

Jessica Lise Vercruysse is licensed to practice in Connecticut (license number 70713) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033771126.

Contact Information

Jessica Lise Vercruysse, MD
112 Mansfield Ave,
Willimantic, CT 06226-2045
(904) 265-6850
Not Available

Map and Direction




Physician's Profile

Full NameJessica Lise Vercruysse
GenderFemale
SpecialityEmergency Medicine
Location112 Mansfield Ave, Willimantic, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1033771126
  • Provider Enumeration Date: 06/28/2019
  • Last Update Date: 06/22/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 9032448386
  • Enrollment ID: I20220627002379

Medical Identifiers

Medical identifiers for Jessica Lise Vercruysse such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033771126NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 4351045618 (Michigan)Secondary
207P00000XEmergency Medicine 70713 (Connecticut)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Lise Vercruysse allows following entities to bill medicare on her behalf.
Entity NameNortheast Emergency Medicine Specialists Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982889598
PECOS PAC ID: 8729157797
Enrollment ID: O20080516000028
Entity NameNems Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114482882
PECOS PAC ID: 2466792833
Enrollment ID: O20190321000650

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Lise Vercruysse is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jessica Lise Vercruysse, MD
112 Mansfield Ave,
Willimantic, CT 06226-2045

Ph: () -		Jessica Lise Vercruysse, MD
112 Mansfield Ave,
Willimantic, CT 06226-2045

Ph: (904) 265-6850

Reviews and Comments


Emergency Medicine Doctors in Willimantic, CT

Dr. Craig D Sweeney, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1703 Main St, Willimantic, CT 06226
Phone: 860-456-1252    
Thomas Gilmore,
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 112 Mansfield Ave, Windham Hospital, Willimantic, CT 06226
Phone: 215-955-9837    
Dr. Eugene A Winchester, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 112 Mansfield Ave, Willimantic, CT 06226
Phone: 860-456-6715    
Dr. Orland Edwin Donald, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 112 Mansfield Ave, Windham Hospital Emergency Dept, Willimantic, CT 06226
Phone: 860-456-6715    
Marc L. Guttman, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 112 Mansfield Ave, Willimantic, CT 06226
Phone: 860-456-9116    Fax: 860-963-6368
Neil Moynihan, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 112 Mansfield Ave, Willimantic, CT 06226
Phone: 860-423-6410    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.