Individual provider Active NPI

Nicholas J. Palermo, D.O.

  • Family Medicine Physician
  • Manchester, CT
National Provider Identifier
1366419632
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
CT000151 Issued in CT
Practice address
257 E Center St
The Optimum Health Building
Manchester, CT 06040-5214
Phone
(860) 645-3927
Fax
(860) 643-2531
NPI assigned
Mar 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X CT000151 CT Primary

Addresses

Primary practice location

257 E Center St
The Optimum Health Building
Manchester, CT 06040-5214

Mailing address

49 Erie St
Manchester, CT 06040-7034
Phone (860) 647-7055

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050630000657 CT Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 9739125634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

315 E Ctr St
Manchester, CT 06040-5251
Phone (860) 533-0179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CT000151CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas J. Palermo DO, PC Family Medicine CurrentSince May 26, 2005 Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Family Medicine Past Accepting new patients
Glastonbury Osteopathic, LLC Family Medicine Past Accepting new patients

Locations

257 E Center St
Manchester, CT 06040
Phone (860) 643-5101

315 E Center St
Manchester, CT 06040
Phone (860) 533-0179

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366419632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 ERIE ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060407034",
            "telephone_number": "860-647-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 E CENTER ST",
            "address_2": "THE OPTIMUM HEALTH BUILDING",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405214",
            "telephone_number": "860-645-3927",
            "fax_number": "860-643-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "NICHOLAS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "CT000151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.