Individual provider Active NPI

Holly Pelletier, PA

  • Medical Physician Assistant
  • Manchester, NH
National Provider Identifier
1245249010
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0415 Issued in 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
Last updated
Aug 8, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0415 NH Primary

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

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000968 NH Practitioner - Physician Assistant 4183618796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
415NHMDPsychologist
0415NHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Medical Center CurrentSince Aug 1, 2002 Accepting new patients
Appledore Medical Group Dba Woodbury Family Practice CurrentSince Feb 1, 2025 Accepting new patients
Appledore Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients
Catholic Medical Center CurrentSince Aug 1, 2002 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

  • Direct secure messaging: holly.pelletier@hca6.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1245249010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WEBSTER ST STE 110",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042552",
            "telephone_number": "603-622-6491",
            "fax_number": "603-663-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 WEBSTER ST STE 110",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042552",
            "telephone_number": "603-622-6491",
            "fax_number": "603-663-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "HOLLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.