Michael Todd Pendolino, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2152 Issued in MA

Practice address

20 Cummings Park
Woburn, MA 01801

Phone

(781) 938-9400

Fax

(781) 938-9323

NPI assigned

Jul 28, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Woburn Family Chiropractic Inc

  • Chiropractor
  • Woburn, MA
  • NPI 1427160688
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194739573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-938-9400",
            "fax_number": "781-938-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-938-9400",
            "fax_number": "781-938-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDOLINO",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2611483",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "460083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA7544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y39772",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1697021",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Pedicini, WHNP-BC
• Florence Pelissier, COTA
• Scott Pelletier
• Maria Pelosi
• Staci Pendergast, M.ED. CCC-SLP
• Katherine Perakis
• Ralphy Percy
• Helena D Pereira, RPH
• Tracy Pereira
• Performance Through Function PLLC

• Chiropractor in Woburn, MA
• Providers in Woburn, MA by specialty
• Chiropractor in Massachusetts

• 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.