Individual provider Active NPI

Michelle Elizabeth Dilorenzo, DO

  • Pediatrics Physician
  • Essex, CT
National Provider Identifier
1073526786
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
000442 Issued in CT
Practice address
One Wildwood Medical Center
Essex, CT 06426
Phone
(860) 767-0168
Fax
(860) 767-1803
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 000442 CT Primary

Addresses

Primary practice location

One Wildwood Medical Center
Essex, CT 06426

Mailing address

One Wildwood Medical Center
Essex, CT 06426
Phone (860) 767-0168

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
000442CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wildwood Pediatrics and Adolescent Medicine LLC Pediatrics Past 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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073526786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE WILDWOOD MEDICAL CENTER",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "06426",
            "telephone_number": "860-767-0168",
            "fax_number": "860-767-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE WILDWOOD MEDICAL CENTER",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "06426",
            "telephone_number": "860-767-0168",
            "fax_number": "860-767-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILORENZO",
        "first_name": "MICHELLE",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "000442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.