Active NPI
Patricia A Pisanelli, M.D.
- Surgery Physician
- Worcester, MA
National Provider Identifier
1235234618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 216567
- Practice address
- Distefano Medical Group
10 Winthrop Street
Worcester, MA 01655 - Phone
- (802) 388-9885
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 216567 | MA | Primary |
Addresses
Primary practice location
Distefano Medical Group
10 Winthrop Street
Worcester, MA 01655
Mailing address
463 East Main Street
East Middlebury, VT 05740
Phone (802) 388-9885
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216567 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235234618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "463 EAST MAIN STREET",
"city": "EAST MIDDLEBURY",
"state": "VT",
"postal_code": "05740",
"telephone_number": "802-388-9885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DISTEFANO MEDICAL GROUP",
"address_2": "10 WINTHROP STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01655",
"telephone_number": "802-388-9885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PISANELLI",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "216567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, 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.