Individual provider Active NPI

Christopher J Panebianco, APRN

  • Acute Care Nurse Practitioner
  • New London, CT
National Provider Identifier
1225792500
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
10249 Issued in CT
Practice address
365 Montauk Ave
New London, CT 06320-4700
Phone
(860) 442-0711
NPI assigned
Oct 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 10249 CT Primary

Addresses

Primary practice location

365 Montauk Ave
New London, CT 06320-4700

Mailing address

48 South St
Cromwell, CT 06416-2265
Phone (203) 464-6469

Other practice location 1

25 Wells St
Westerly, RI 02891-2922
Phone (401) 596-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220126001869 CT Practitioner - Nurse Practitioner 5395137244 Reassigns benefits to 1 organization
I20220714000892 RI Practitioner - Nurse Practitioner 5395137244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Associates LLCGroup PAC ID 9234156985, 208 clinicians

Practice addresses (Care Compare)

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

Hospital & facility affiliations

  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England, P.C. Acute Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cpanebianco498200@direct.ynhh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1635033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1225792500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SOUTH ST",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162265",
            "telephone_number": "203-464-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Wells St",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028912922",
            "country_code": "US",
            "telephone_number": "401-596-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANEBIANCO",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-24",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "10249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.