Active NPI
Nicholas Pantelakis, M.D.
- Specialist
- Peabody, MA
National Provider Identifier
1205925179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 33413
- Practice address
- 6 Essex Center Dr
Suite 201
Peabody, MA 01960-2910 - Phone
- (978) 531-4848
- Fax
- (978) 531-6036
- NPI assigned
- Oct 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 33413 | MA | Primary |
Addresses
Primary practice location
6 Essex Center Dr
Suite 201
Peabody, MA 01960-2910
Mailing address
44 Bayberry Rd
Newburyport, MA 01950-3466
Phone (978) 465-7903
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033413 | Other | MA | TUFTS HEALTH |
| 93625 | Other | MA | AETNA |
| 13387 | Other | MA | HARVARD-PILGRIM |
| 002009 | Other | MA | ONE HEALTH |
| 329847 | Other | MA | UNITED HEALTHCARE |
| 39291 | Other | MA | FALLON |
| 993595 | Other | MA | NETWORK HEALTH |
| MO8620 | Other | MA | BCBS |
| 199310 | Other | MA | CIGNA |
| 199310 | Other | MA | HEALTHSOURCE |
| 2027356 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33413 | MA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205925179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 BAYBERRY RD",
"city": "NEWBURYPORT",
"state": "MA",
"postal_code": "019503466",
"telephone_number": "978-465-7903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 ESSEX CENTER DR",
"address_2": "SUITE 201",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602910",
"telephone_number": "978-531-4848",
"fax_number": "978-531-6036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANTELAKIS",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MA",
"license": "33413",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH",
"identifier": "033413",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "93625",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD-PILGRIM",
"identifier": "13387",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH",
"identifier": "002009",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "329847",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "39291",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "993595",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "MO8620",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "199310",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "199310",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2027356",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- 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.