Individual provider Active NPI

Michael A Pellegrino, D.O.

  • Emergency Medicine Physician
  • Fall River, MA
National Provider Identifier
1114060506
Registry record updated Jan 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
151013 Issued in MA
Practice address
Charlton Memorial Hosp
Fall River, MA 00000
Phone
(508) 679-3131
Fax
(774) 628-9857
NPI assigned
Feb 15, 2007
Last updated
Jan 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 151013 MA Primary

Addresses

Primary practice location

Charlton Memorial Hosp
Fall River, MA 00000

Mailing address

6 Melissa Ann LN
Mattapoisett, MA 02739-1077
Phone (508) 679-3131

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
I20060505000784 MA Practitioner - General PracticePractitioner - Emergency Medicine 7113938192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of New England, College of Osteo Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Physicians CorporationGroup PAC ID 0244518454, 28 clinicians

Practice addresses (Care Compare)

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-7215

49 State Rd
Suite 102
Dartmouth, MA 02747-3322
Phone (508) 848-8089

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151013MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Hospitals Group, Inc Current Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Jun 24, 1996 Accepting new patients
Empower Therapeutics, PLLC CurrentSince Dec 1, 2024 Accepting new patients
Southcoast Hospitals Group, Inc CurrentSince Jun 24, 1996 Accepting new patients

Locations

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

49 State Rd
#102
North Dartmouth, MA 02747
Phone (508) 848-8089

Interoperability endpoints

  • Direct secure messaging: mpellegrino15827@direct.southcoast.org

Organizations & group practices 5

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 1

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1114060506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MELISSA ANN LN",
            "city": "MATTAPOISETT",
            "state": "MA",
            "postal_code": "027391077",
            "telephone_number": "508-679-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHARLTON MEMORIAL HOSP",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "00000",
            "telephone_number": "508-679-3131",
            "fax_number": "774-628-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "151013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.