Individual provider Active NPI

Marisa Parise Petrucelli, D.O.

  • Anesthesiology Physician
  • Newton, NJ
National Provider Identifier
1043506637
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OT014334 Issued in PA
Practice address
175 High St
Newton, NJ 07860-1004
Phone
(973) 383-2121
NPI assigned
Jun 22, 2011
Last updated
Aug 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OT014334 PA Primary

Addresses

Primary practice location

175 High St
Newton, NJ 07860-1004

Mailing address

11781 Lee Jackson Memorial Hwy
Suite 550
Fairfax, VA 22033-3309
Phone (571) 777-5106

Other identifiers 1

IdentifierTypeStateIssuer
0412830MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20140730001031 NJ Practitioner - Anesthesiology 7214153113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Morristown PAGroup PAC ID 7315906591, 168 clinicians

Practice addresses (Care Compare)

175 High St
Newton, NJ 07860-1004
Phone (973) 383-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.76 of 100Reported as group
Quality
78.69
Improvement activities
40
Cost
74.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT014334PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince Aug 1, 2014 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Anesthesiology CurrentSince Apr 5, 2017 Accepting new patients
Specialty Surgical Center, LLC Anesthesiology CurrentSince May 13, 2017 Accepting new patients
Anesthesia Associates of Morristown PA CurrentSince May 29, 2019 Accepting new patients
Specialty Surgical Center LLC Current Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients

Locations

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

111 Madison Ave
Morristown, NJ 07960
Phone (201) 943-5991

175 High St
Newton, NJ 07860
Phone (973) 383-2121

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

605 Broad Ave
Ste 106
Ridgefield, NJ 07657
Phone (908) 527-9863

380 Lafayette Rd
Ste 110
Sparta, NJ 07871
Phone (973) 940-3166

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

Organizations & group practices 6

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1043506637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11781 LEE JACKSON MEMORIAL HWY",
            "address_2": "SUITE 550",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333309",
            "telephone_number": "571-777-5106",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HIGH ST",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078601004",
            "telephone_number": "973-383-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCELLI",
        "first_name": "MARISA",
        "middle_name": "PARISE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "OT014334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0412830",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, NJ

Sources for this page

Verify at the official NPI Registry.