Individual provider Active NPI

Marcelle L Piccolello, MD

  • Diagnostic Radiology Physician
  • Warwick, RI
National Provider Identifier
1023092483
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD08621 Issued in RI
Practice address
125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone
(401) 432-2520
Fax
(401) 453-8220
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 8621 RI
Diagnostic Radiology Physician 2085R0202X MD08621 RI Primary

Addresses

Primary practice location

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Mailing address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2520

Other identifiers 14

IdentifierTypeStateIssuer
008621OtherBLUE SHIELD
008621OtherTUFTS
3202330OtherMASSMEDICAID
004953OtherBLUE CHIP
07003962OtherHOSPITAL PIN
300067429OtherRAILROAD MEDICARE
3202330OtherHEALTHYSTART
720051601OtherCIGNA
000000001988OtherNHPRI
003111523OtherCT MED ASSISTANCE
1600203OtherUNITED HEALTH PLANS
240155OtherW & I PILGRIM
7003962OtherRIMEDICALASSISTANCE
240155OtherRIHPILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8621RIMDDiagnostic Radiology Physician
MD08621RIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Medical Imaging Inc Diagnostic Radiology PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1023092483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCOLELLO",
        "first_name": "MARCELLE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "8621",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD08621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "008621",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "008621",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSMEDICAID",
            "identifier": "3202330",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "004953",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL PIN",
            "identifier": "07003962",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300067429",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYSTART",
            "identifier": "3202330",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "720051601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRI",
            "identifier": "000000001988",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MED ASSISTANCE",
            "identifier": "003111523",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLANS",
            "identifier": "1600203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W & I PILGRIM",
            "identifier": "240155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIMEDICALASSISTANCE",
            "identifier": "7003962",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIHPILGRIM",
            "identifier": "240155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.