Robert F Pellegrino Jr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00452600 Issued in NJ

Practice address

3 Cooper PLZ
Camden, NJ 08103

Phone

(856) 342-2448

NPI assigned

Nov 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Specialty

Physician Assistant

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Department of Medicine Group PAGroup PAC ID 2163335878, 474 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpellegrino76502@direct.cooperhealth.edu

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.

• CMC Department of Medicine Group PA

  • Cardiovascular Disease Physician
  • Camden, NJ
  • NPI 1609908094
  Medicare reassignment Care Compare group NPD
• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD
• Cooper Anesthesia Associates, PC

  • Anesthesiology Physician
  • Camden, NJ
  • NPI 1447207147
  NPD (past)
• Camp Hill Emergency Physicians LLC

  • Emergency Medicine Physician
  • Camp Hill, PA
  • NPI 1720037997
  NPD (past)
• Carlisle Medical Group, LLC

  • Family Medicine Physician
  • Lancaster, PA
  • NPI 1538396528
  NPD (past)
• Internal Medicine at Lakeside

  • Internal Medicine Physician
  • Brockport, NY
  • NPI 1083939722
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1235310186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-342-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "ROBERT",
        "middle_name": "F",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000693L",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00452600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1568491",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS FREEDOM BLUE",
            "identifier": "2013663",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Paynter, RN,APN
• William Eric Paynter Jr., FNP-BC, APN
• Markian Yuriy Pazuniak, M.D
• Mitchell Aaron Pearlman, CRNA
• Lisa Vanchhawng Pedroza, MD
• Alexis Elise Pelletier-Bui, M.D.
• Mark J Pello, M.D.
• Shari Peltz, LCSW
• Jesus Francisco Penabad, MD
• Norman E Pennington, MD

• Medical Physician Assistant in Camden, NJ
• Providers in Camden, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.