Amato Polselli Jr., M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

012942 Issued in ME

Practice address

32 Morison Ave.
Wells, ME 04090-1329

Phone

(207) 251-4425

Fax

(207) 251-4425

NPI assigned

Nov 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amato.polselli.p4@direct.bvchc.nextgenshare.com

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.

• Tri-County Community Action Agency

  • Federally Qualified Health Center (FQHC)
  • Johnston, RI
  • NPI 1396780086
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215007109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1329",
            "address_2": "32 MORISON AVE.",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040901329",
            "telephone_number": "207-251-4425",
            "fax_number": "207-251-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 MORISON AVE.",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040901329",
            "telephone_number": "207-251-4425",
            "fax_number": "207-251-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSELLI",
        "first_name": "AMATO",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "012942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Occupational Health Centers of the Southwest P.a. (Concentra Medical Center)
• Anna Olsen
• Richard W. Ouellette
• Jane Pelletier, PA-C
• Hannah Pattison Pohli, M.A., CCC-SLP
• Karolina Pray, ND
• Prime Care Medical Supplies Inc.
• Anne Elizabeth Pulsifer, PH.D.
• Darcy Ramsdell, CCC-SLP
• Patrick J Randall, DMD

• Pediatrics Physician in Wells, ME
• Providers in Wells, ME by specialty
• Pediatrics Physician in Maine

• 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.