Holly Pelletier, PA
Individual provider Active NPI Medical Physician Assistant · Manchester, NH
NPI 1245249010 · NPPES record last updated Aug 8, 2008
Key facts
- NPI
- 1245249010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 0415 (NH)
- Practice address
- 57 Webster St Ste 110
Manchester, NH 03104-2552 - Phone
- (603) 622-6491
- Fax
- (603) 663-1922
- NPI assigned
- Aug 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Appledore Medical Group Inc
Practice addresses (Care Compare)
330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-7112
Phone (603) 431-5242
57 Webster St
Suite 110
Manchester, NH 03104-2552
Phone (603) 622-6491
Hospital & facility affiliations
- Catholic Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040414000968 | NH | Practitioner - Physician Assistant | 4183618796 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 415 | NH | MD | Psychologist |
| 0415 | NH | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Medical Center | Current |
Accepting new patients | |
| Appledore Medical Group Dba Woodbury Family Practice | Current |
Accepting new patients | |
| Catholic Medical Center | Current |
Accepting new patients | |
| Appledore Medical Group, Inc | Current |
Accepting new patients |
Locations
5 Washington Pl
Ste 1A
Bedford, NH 03110
Phone (603) 663-8060
57 Webster St
Manchester, NH 03104
Phone (603) 622-6491
57 Webster St
Ste 110
Manchester, NH 03104
Phone (603) 622-6491
330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242
330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Interoperability endpoints
- holly.pelletier@hca6.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0415 | NH | Yes |
Addresses
Primary practice location
57 Webster St Ste 110
Manchester, NH 03104-2552
Mailing address
57 Webster St Ste 110
Manchester, NH 03104-2552
Phone (603) 622-6491
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 970026231 | Other | RAILROAD MEDICARE | |
| 30332475 | Medicaid | NH |
Other providers in Manchester, NH
- Arthur Pechilis
- Katherine D Pecorelli
- Sarah Pecoroni
- Jillian Pelchat
- Pelican Transportation
- Maeghan M Pelletier
- Samantha Pelletier
- Lisa Pelunis-Messier
- Marina Pena
- Paul Michael Pender
All providers in Manchester, NH · Medical Physician Assistant in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.