Individual provider Active NPI

Angelina Palombo, M.D.

  • Family Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1205286143
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LP03786 Issued in RI
Practice address
111 Brewster St
FCC Team a
Pawtucket, RI 02860-4474
Phone
(401) 729-2304
Fax
(401) 729-2541
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LP03786 RI Primary

Addresses

Primary practice location

111 Brewster St
FCC Team a
Pawtucket, RI 02860-4474

Mailing address

1126 Hartford Ave
Johnston, RI 02919-7109
Phone (401) 519-1940

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
I20230119003172 MA Practitioner - Family Practice 1557655222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Health Services IncGroup PAC ID 0345146213, 56 clinicians

Practice addresses (Care Compare)

735 Attucks LN
Hyannis, MA 02601-1867
Phone (508) 778-0300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Harbor Health Services, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Harbor Health Services, Inc. Past Accepting new patients

Locations

735 Attucks Ln
Hyannis, MA 02601
Phone (508) 778-0300

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

Interoperability endpoints

  • Direct secure messaging: apalombo620698@direct.ochin.org

Organizations & group practices 3

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.

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1205286143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029197109",
            "telephone_number": "401-519-1940",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "address_2": "FCC TEAM A",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604474",
            "telephone_number": "401-729-2304",
            "fax_number": "401-729-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMBO",
        "first_name": "ANGELINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP03786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.