Elyssa A. Pellish, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

234790 Issued in MA

Practice address

55 Lake Ave N
Department of Emergency Medicine
Worcester, MA 01655-0002

Phone

(508) 421-1400

Fax

(508) 421-1490

NPI assigned

Dec 5, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Emergency Medicine

Education

University of Massachusetts Medical School, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, 1,693 clinicians

Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002
• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elyssa.pellish.npi1407830201.reliant@direct.optumcare.masshiway.net

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.

• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1194765438
  Medicare reassignment Care Compare group NPD
• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  Medicare reassignment Care Compare group NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Emergency Medical Services (Emergency Medicine) Physician
  • Boston, MA
  • NPI 1952358533
  Medicare reassignment NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Multi-Specialty Clinic/Center
  • Boston, MA
  • NPI 1861216038
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Memorial Hospital

  • General Acute Care Hospital
  • Pawtucket, RI
  • NPI 1548696941

  Emergency Medicine

  NPD (past)

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

• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation
• Mount Auburn Hospital

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1689670259
  Care Compare affiliation

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1407830201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLISH",
        "first_name": "ELYSSA",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "234790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2152452",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Pelletier
• Joseph Pelletier
• Kerrianne Pelletier
• Nicholas Joseph Pelletier
• Janet Pelletti
• Danielle May Peloquin
• Amanda Marie Pelosi, RN
• Michala Peltak, PA-C
• Kailee Peltier
• Donald E Pelto, DPM

• Emergency Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.