Individual provider Active NPI

Alfred Pisano, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Bethesda, MD
National Provider Identifier
1063823755
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
282390 Issued in MA
Practice address
8901 Wisconsin Ave
BLDG 1, Floor 19, Room 19107
Bethesda, MD 20889-0004
Phone
(301) 319-8373
Fax
(301) 295-9186
NPI assigned
May 15, 2014
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 282390 MA
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery of the Spine Physician 207XS0117X 282390 MA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
BLDG 1, Floor 19, Room 19107
Bethesda, MD 20889-0004

Mailing address

8901 Rockville Pike BLDG 19
Bethesda, MD 20889-0001
Phone (305) 968-4378

Other practice location 1

55 Fruit St Bldg 3550
Boston, MA 02114-2621
Phone (305) 968-4378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200820000959 MA Practitioner - Orthopedic Surgery 1759707763 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282390MAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Aug 1, 2020 Accepting new patients
Brigham & Womens Physicians Organization Inc Orthopaedic Surgery CurrentSince Jul 27, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Bldg 3550
Boston, MA 02114
Phone (305) 968-4378

75 Francis St
Boston, MA 02115

254 2nd Ave
Needham Heights, MA 02494
Phone (781) 416-8414

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1063823755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE BLDG 19",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "305-968-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "BLDG 1, FLOOR 19, ROOM 19107",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-319-8373",
            "fax_number": "301-295-9186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St Bldg 3550",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "305-968-4378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PISANO",
        "first_name": "ALFRED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "282390",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MA",
            "license": "282390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.