Individual provider Active NPI

Joseph Pezzulo, ACNP-BC

  • Acute Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1376778803
Registry record updated Sep 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN2258970 Issued in MA
Practice address
881 Commonwealth Avenue, West
Boston, MA 02215
Phone
(617) 353-3573
NPI assigned
May 28, 2009
Last updated
Sep 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2258970 MA Primary
Acute Care Nurse Practitioner 363LA2100X ARNP9220338 FL

Addresses

Primary practice location

881 Commonwealth Avenue, West
Boston, MA 02215

Mailing address

780 Boylston St
17E
Boston, MA 02199-7820
Phone (305) 801-1045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110719000784 FL Practitioner - Nurse Practitioner 9638347594 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

2201 45TH St
West Palm Beach, FL 33407-2047
Phone (561) 842-6141

322 SW Pine Island Rd
Fawcett Memorial
Cape Coral, FL 33991-2057
Phone (941) 249-6858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2258970MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services LLC CurrentSince Mar 19, 2012 Accepting new patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Duval Emergency Group LLC CurrentSince Jun 15, 2011 Accepting new patients
FL-I Medical Services, LLC Current Accepting new patients
East Florida Emergency Physician Group LLC Past Accepting new patients
Emergency Physician Solutions of South Florida, LLC Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

3663 S Miami Ave
Miami, FL 33133
Phone (305) 285-2131

160 NW 170th St
North Miami Beach, FL 33169
Phone (305) 585-8957

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

2201 45th St
West Palm Beach, FL 33407
Phone (561) 842-6141

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Interoperability endpoints

  • Direct secure messaging: jpezzulo@bcp-fl.direct.office.nextgen.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284163200000",
    "number": "1376778803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 BOYLSTON ST",
            "address_2": "17E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021997820",
            "telephone_number": "305-801-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 COMMONWEALTH AVENUE, WEST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-353-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZULO",
        "first_name": "JOSEPH",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2010-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2258970",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9220338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.