NPIMap

Individual provider Active NPI

Andrew W Pellechia, PA

  • Physician Assistant
  • Stoneham, MA
National Provider Identifier
1265092423
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8075 Issued in MA
Practice address
92 Montvale Ave Ste 1400
Stoneham, MA 02180-3629
Phone
(781) 279-7040
NPI assigned
Jun 19, 2019
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA8075 MA Primary

Addresses

Primary practice location

92 Montvale Ave Ste 1400
Stoneham, MA 02180-3629

Mailing address

92 Montvale Ave Ste 1400
Stoneham, MA 02180-3629
Phone (781) 279-7040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190730002297 NY Practitioner - Physician Assistant 7214263151 Reassigns benefits to 1 organization
I20190828000447 NJ Practitioner - Physician Assistant 7214263151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians

Practice addresses (Care Compare)

1133 Westchester Ave
White Plains, NY 10604-3516
Phone (646) 797-8973

37 S Broad St
Pawcatuck, CT 06379-7909
Phone (860) 495-1919

535 E 70TH St
New York, NY 10021-4823
Phone (646) 797-8471

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023625NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Jul 1, 2025 Accepting new patients
Augustin Physical Therapy and Sports Rehab LLC PastSince Nov 8, 2022 Accepting new patients

Locations

535 E 70th St
New York, NY 10021

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 3

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 11

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1265092423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE STE 1400",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803629",
            "telephone_number": "781-279-7040",
            "fax_number": "781-279-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE STE 1400",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803629",
            "telephone_number": "781-279-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLECHIA",
        "first_name": "ANDREW",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.