Michael Wayne Pellecchia, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

392 Issued in WY

Practice address

2526 Seymour Ave
Cheyenne, WY 82001-3159

Phone

(307) 634-9653

Fax

(307) 638-8256

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Plains Mental Health Associates LLCGroup PAC ID 9537422332, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21060/brand/4/csg/1/fhir/r4

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.

• Great Plains Mental Health Associates LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Omaha, NE
  • NPI 1831614064

  Clinical

  Medicare reassignment Care Compare group NPD
• Oneworld Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1952330649
  Medicare reassignment

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1043399116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 SEYMOUR AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013159",
            "telephone_number": "307-634-9653",
            "fax_number": "307-638-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 SEYMOUR AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013159",
            "telephone_number": "307-634-9653",
            "fax_number": "307-638-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLECCHIA",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "392",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18753",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF WY",
            "identifier": "312188",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breiana Pedersen
• Veronica Eiting Pedersen, LCSW
• Pediatric Dentistry LLC
• Pediatric Dentistry, P.C.
• Kim M. Peeples, LPC
• Regan Pelloquin
• Jenny Peltz
• Donja Pemberton
• Darren Pennington
• Teresa Pennington, LPC

• Clinical Social Worker in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.