Individual provider Active NPI

Andrea Palumbo, MD

  • Pediatrics Physician
  • Bedford, NH
National Provider Identifier
1215942016
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
13051 Issued in NH
Practice address
360 Route 101
Unit 8
Bedford, NH 03110-5030
Phone
(603) 472-5860
Fax
(603) 472-5918
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13051 NH Primary

Addresses

Primary practice location

360 Route 101
Unit 8
Bedford, NH 03110-5030

Mailing address

360 Route 101
Unit 8
Bedford, NH 03110-5030
Phone (603) 472-5860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20110331000793 NH Practitioner - Pediatric Medicine 0042493801 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13051NHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network Pediatrics CurrentSince Jan 16, 2012 Accepting new patients

Locations

25 Leavey Dr
Bedford, NH 03110
Phone (603) 472-7233

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

360 Route 101
Ste 8
Bedford, NH 03110
Phone (603) 472-5860

25 Leavey Dr
Unit 1
Bedford, NH 03110

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

4 Elliot Way
Ste 105
Manchester, NH 03103
Phone (603) 626-5113

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1215942016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "address_2": "UNIT 8",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105030",
            "telephone_number": "603-472-5860",
            "fax_number": "603-472-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "address_2": "UNIT 8",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105030",
            "telephone_number": "603-472-5860",
            "fax_number": "603-472-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "ANDREA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "13051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.