Joseph Thaddeus Azzarello, M.D., PH.D.

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

32678 Issued in OK

Practice address

1180 Pocahontas St Ste 400
Norfolk, VA 23511-2428

Phone

(757) 910-3009

NPI assigned

Mar 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1003200866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 POCAHONTAS ST STE 400",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235112428",
            "telephone_number": "757-910-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 POCAHONTAS ST STE 400",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235112428",
            "telephone_number": "757-910-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZARELLO",
        "first_name": "JOSEPH",
        "middle_name": "THADDEUS",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "OK",
            "license": "32678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "32678",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joseph.azzarello@lpd28.navy.mil",
            "affiliation": "N",
            "endpointDescription": "joseph.azzarello@lpd28.navy.mil",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1180 Pocahontas St Ste 400",
            "city": "Norfolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "235112428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Military Health Care Provider in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Military Health Care Provider in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.