Anita Petruzzelli, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

034143 Issued in CT

Practice address

416 Highland Ave
BLDG B
Cheshire, CT 06410

Phone

(203) 272-1688

Fax

(203) 272-2447

NPI assigned

Jul 11, 2006

Last updated

Nov 30, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 7, 2014 through Mar 7, 2028

Specialty

Obstetrics/Gynecology

Education

George Washington University School of Medicine, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138

  Obstetrics & Gynecology

  NPD (past)
• Saint Raphael Healthcare System Affiliated Physicians Inc

  dba Affiliated Physicians of Saint Raphael

  • Neurology Physician
  • New Haven, CT
  • NPI 1063744001

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1285668350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 HIGHLAND AVE",
            "address_2": "BLDG B",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410",
            "telephone_number": "203-272-1688",
            "fax_number": "203-272-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 HIGHLAND AVE",
            "address_2": "BLDG B",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410",
            "telephone_number": "203-272-1688",
            "fax_number": "203-272-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUZZELLI",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CT",
            "license": "034143",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CT",
            "license": "034143",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "034143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arnold Pellegrini
• Heather Lee Peracchio, M.S., R.D., CD-N
• Caitlyn Perillo, OT
• Brittney Perry, COTA/L
• Perspectives Center for Care, Inc.
• Justine Phee, SLP
• Phoenix Therapy LLC
• Physical Therapy & Pilates Restoration LLC
• Piece to Peace, LLC
• Pieces That Fit

• Obstetrics & Gynecology Physician in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Obstetrics & Gynecology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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; Opt Out Affidavits.
• 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.