Individual provider Active NPI

Aida Cerundolo, M.D.

  • Emergency Medicine Physician
  • Lebanon, NH
National Provider Identifier
1265497697
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11986 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756
Phone
(603) 650-7254
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11986 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-7254

Other practice location 1

1 Parkland Dr
Derry, NH 03038-2746
Phone (603) 421-2220

Other identifiers 4

IdentifierTypeStateIssuer
1265497697OtherNHANTHEM BCBS
AA188476OtherNHHARVARD PILGRIM HEALTHCARE
110004423AMedicaidMA
30203570MedicaidNH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040331000421 NH Practitioner - Emergency Medicine 9133111297 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Massachusetts Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Peck Day Memorial Hospital 132 clinicians
St. Joseph Hospital of Nashua NH 271 clinicians

Practice addresses (Care Compare)

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 884-5600

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Nashua, NH, CCN 300011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital CurrentSince Jul 28, 2019 Accepting new patients
Littleton Hospital Association CurrentSince Oct 9, 2019 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic Emergency Medicine CurrentSince Aug 12, 2019 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 2, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 2, 2025 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Jul 28, 2019 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Oct 23, 2024 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Oct 23, 2024 Accepting new patients
Littleton Hospital Association CurrentSince Oct 9, 2019 Accepting new patients
Merrimack Emergency Physicians Past Accepting new patients
Borthwick Emergency Physicians, LLC Emergency Medicine PastSince Dec 15, 2019 Accepting new patients
Southcoast Hospitals Group, Inc Past Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

Interoperability endpoints

  • Direct secure messaging: acerundolo2759818@direct.bsmhealth.org
  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: acerundolo370009@direct.dartmouth-hitchcock.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 2

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1265497697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03756",
            "telephone_number": "603-650-7254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Parkland Dr",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030382746",
            "country_code": "US",
            "telephone_number": "603-421-2220",
            "fax_number": "603-421-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERUNDOLO",
        "first_name": "AIDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "11986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1265497697",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCARE",
            "identifier": "AA188476",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110004423A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203570",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.