NPIMap

Individual provider Active NPI

Peter Bellezza

  • Foot & Ankle Surgery Podiatrist
  • Bristol, CT
National Provider Identifier
1346660776
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
957 Issued in CT
Practice address
15 Riverside Ave
Bristol, CT 06010
Phone
(860) 585-3333
NPI assigned
Apr 24, 2014
Last updated
Nov 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 957 CT Primary

Addresses

Primary practice location

15 Riverside Ave
Bristol, CT 06010

Mailing address

PO Box 2828
Bristol, CT 06011-2828
Phone (860) 585-3773

Other practice location 1

35 Pearl St
New Britain, CT 06051-2644
Phone (860) 225-3587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA, MN, TX4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20220411001270 SD Practitioner - Podiatry 6709006406 Reassigns benefits to 1 organization
I20221109003308 IA Practitioner - Podiatry 6709006406 Reassigns benefits to 1 organization
I20221202001035 MN Practitioner - Podiatry 6709006406 Reassigns benefits to 1 organization
I20230609000650 TX Practitioner - Podiatry 6709006406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, shared by 52 NPIs, 957 clinicians

Practice addresses (Care Compare)

1100 S 10TH Ave
Rock Rapids, IA 51246-2020

1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (605) 504-1100

1200 1St Ave E
Spencer, IA 51301-4342

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

300 W 5TH St
Miller, SD 57362-1238
Phone (605) 853-0158

600 9TH Ave N
Sibley, IA 51249-1012
Phone (712) 754-2900

6100 S Louise Ave
Sioux Falls, SD 57108-6029

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision30
Removal of tissue794
Removal of skin lesions1-10
Removal of nail tissue42
Removal or shaving of skin growth12
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Multi-Specialty CurrentSince Mar 7, 2022 Accepting new patients
Avera McKennan Multi-Specialty CurrentSince Oct 1, 2022 Accepting new patients
Avera McKennan Multi-Specialty CurrentSince Oct 1, 2022 Accepting new patients
Avera McKennan Multi-Specialty Current Accepting new patients
Flandreau Santee Sioux Tribe Multi-Specialty CurrentSince May 2, 2023 Accepting new patients
Avera McKennan CurrentSince Mar 7, 2022 Accepting new patients
Avera McKennan Multi-Specialty Current Accepting new patients
Avera McKennan Multi-Specialty Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

911 5th Ave SW
Pipestone, MN 56164
Phone (507) 825-5811

403 W Broad Ave
Flandreau, SD 57028
Phone (605) 997-2642

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

6100 S Louise Ave
Ste 2100
Sioux Falls, SD 57108
Phone (605) 504-1100

Organizations & group practices 9

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.

  • Avera McKennan

    dba Avera Medical Group Orthopedics and Sports Medicine

    • Orthopaedic Surgery Physician
    • Sioux Falls, SD
    • NPI 1093262131

    MN, Multi-Specialty

    Medicare reassignment NPD
  • Avera McKennan

    dba Avera Medical Group Womens Health Specialists Sioux Falls

    • Obstetrics & Gynecology Physician
    • Sioux Falls, SD
    • NPI 1336111962

    IA, Multi-Specialty

    Medicare reassignment NPD
  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944

    Multi-Specialty

    Medicare reassignment NPD
  • Flandreau Santee Sioux Tribe
    • Adult Day Care Clinic/Center
    • Flandreau, SD
    • NPI 1437188729

    Multi-Specialty, TX

    Medicare reassignment NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678

    Multi-Specialty

    NPD
  • Avera McKennan

    dba Avera Nephrology

    • Nephrology Physician
    • Sioux Falls, SD
    • NPI 1104892892

    Multi-Specialty

    NPD
  • Avera McKennan

    dba Avera Prince of Peace Outpatient Therapy

    • Multi-Specialty Clinic/Center
    • Sioux Falls, SD
    • NPI 1467786640
    NPD
  • Avera McKennan

    dba Avera Medical Group 69th and Cliff

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1144635863

    Multi-Specialty

    NPD (past)
  • Avera McKennan

    dba Avera McKennan Hospital and University Health Center

    • General Acute Care Hospital
    • Sioux Falls, SD
    • NPI 1568460772
    NPD (past)

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1346660776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2828",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060112828",
            "telephone_number": "860-585-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RIVERSIDE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "860-585-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Pearl St",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060512644",
            "country_code": "US",
            "telephone_number": "860-225-3587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLEZZA",
        "first_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-24",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.