Coral Picillo

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

3150 Menards Dr
Angola, IN 46703-7356

Phone

(260) 266-4005

NPI assigned

Oct 15, 2026

Last updated

Oct 15, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1376449579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 MENARDS DR",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037356",
            "telephone_number": "260-266-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICILLO",
        "first_name": "CORAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nichole Peck, LMHC, NCC
• Dustin R Peck, BS
• Emily Nichole Petrancosta
• Tanya Petras
• Pharmacare Home Medical, LLC
• Practical Family Medicine, LLC
• Pulaski Memorial Hospital (Northern Lakes Nursing & Rehab Center)
• R Wyatt Weaver Jr,M.D.
• Gina Marie Rasler, COTA
• Anne Reitz, N.P.

• Surgical Physician Assistant in Angola, IN
• Providers in Angola, IN by specialty
• Surgical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.