Jose Manuel Panisello, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

050338 Issued in CT

Practice address

20 York St
305 Lci
New Haven, CT 06510-3220

Phone

(203) 785-4651

NPI assigned

Jan 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpanisello64363@direct.ynhh.org

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.

• Yale University

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment NPD
• Yale University

  • Adult Mental Health Clinic/Center
  • Hamden, CT
  • NPI 1134391824
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1306116389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORK STREET,",
            "address_2": "LLCI 305 PEDIATRICS, YALE UNIVERSITY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208064",
            "telephone_number": "203-785-4651",
            "fax_number": "203-785-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "305 LCI",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANISELLO",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CT",
            "license": "050338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Pang
• Philip Pang, M.D.
• Jordyn Panicali, LCSW
• Sheethal Sasidhara Panicker, M.B.B.S.
• Lynn Marie Panico, OTR/L, CHT
• Reema Panjwani, MD
• Dennis Domenic Pannella Sr., CRNA APRN
• Gauri Ganesh Panse, M.D.
• Michael Vincent Pantalon, PH.D.
• Haddon Jacob Pantel, M.D.

• Pediatric Critical Care Medicine Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Pediatric Critical Care Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.