Christopher John Pannucci, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MD60974739 Issued in WA

Practice address

820 S McClellan St Ste 200
Spokane, WA 99204-2456

Phone

(509) 838-7100

Fax

(509) 227-7070

NPI assigned

Apr 9, 2007

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, WA2 enrollments

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 2

Specialty

Plastic and Reconstructive Surgery

Education

Washington University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plastic Surgery Northwest PLLCGroup PAC ID 8022105329, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Plastic Surgery Northwest PLLC

  • Plastic Surgery Physician
  • Spokane, WA
  • NPI 1780714139
  Medicare reassignment Care Compare group NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Adult Services

  dba University of Utah Hospital Infectious Disease Division

  • Infectious Disease Physician
  • Salt Lake City, UT
  • NPI 1033513833
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Plastic Surgicentre, Inc

  dba The Plastic SurgiCentre, Inc

  • Ambulatory Surgical Clinic/Center
  • Spokane, WA
  • NPI 1083780662
  NPD (past)

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

• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1083737738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-3568",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MCCLELLAN ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042456",
            "telephone_number": "509-838-7100",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-581-7719",
            "fax_number": "801-581-5794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANNUCCI",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "8911101-1205",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "UT",
            "license": "8911101-1205",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD60974739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Michelle Pangborn, CTRS
• Shanee Pangelinan
• Sharonna L Pankratz, RN
• Larry Pannell, L.AC.
• Alexandria Jane Panning, MD
• Panoramic Psychiatry LLC
• Corrinne Marie Pantsulaya, CARE COORDINATOR
• Sancyre Par
• Natasha Paranjapye, DDS
• Jillian Kathryn Paras

• Plastic and Reconstructive Surgery Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Plastic and Reconstructive Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.