Angelo Pucillo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2423 Issued in MA

Practice address

585 Lebanon St
Melrose, MA 02176-3225

Phone

(781) 979-3300

NPI assigned

Oct 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emerson Hospital - Hospital, W Concord, MA, CCN 220084

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: pucillo.angelo.epa@direct.partners.masshiway.net
• Direct secure messaging: apucillo28873@tuftsmedicine.direct-ci.com

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.

• Emerson Practice Associates, Inc.

  • Internal Medicine Physician
  • Concord, MA
  • NPI 1508020199
  Medicare reassignment Care Compare group
• Hallmark Health Urgent Care Physicians LLC

  • Emergency Medicine Physician
  • Reading, MA
  • NPI 1184066912
  Medicare reassignment
• Melrose Wakefield Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Melrose, MA
  • NPI 1790730539
  Medicare reassignment

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

• Emerson Hospital

  • General Acute Care Hospital
  • Concord, MA
  • NPI 1922103357
  Care Compare affiliation

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1134318090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GILL ST",
            "address_2": "SUITE 3000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011728",
            "telephone_number": "781-937-4522",
            "fax_number": "781-937-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225",
            "telephone_number": "781-979-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCILLO",
        "first_name": "ANGELO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "2423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Pressley, PSY.D.
• Maura A Previte, A.P.R.N.
• Jolanka Pride, NP
• Kimberly Hayes Principato, NP
• Sophia Maria Proschel
• Jayson Punla
• Martha Quigley, NURSE PRACTITIONER
• Gamal Ragheb, M.D.
• Nivedhitha Ramesh, DMD
• Eric W Ramsey, PA-C

• Physician Assistant in Melrose, MA
• Providers in Melrose, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.