Individual provider Active NPI

Marco Palazzolo, NP-C

  • Nurse Practitioner
  • Beverly, MA
National Provider Identifier
1467078006
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2306719 Issued in MA
Practice address
900 Cummings Ctr Ste 117T
Beverly, MA 01915-6183
Phone
(978) 232-9400
NPI assigned
Jun 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2306719 MA Primary

Addresses

Primary practice location

900 Cummings Ctr Ste 117T
Beverly, MA 01915-6183

Mailing address

46 Revere St
Gloucester, MA 01930-1251
Phone (978) 317-7387

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813001554 MA Practitioner - Nurse Practitioner 8224454855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middleton Family Medicine Urgent Care LLCGroup PAC ID 0042533218, 74 clinicians

Practice addresses (Care Compare)

147 S Main St
Middleton, MA 01949-2446
Phone (978) 774-2555

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2306719MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Middleton Family Medicine Urgent Care, LLC CurrentSince Jul 22, 2024 Accepting new patients

Locations

147 S Main St
Middleton, MA 01949
Phone (978) 774-2555

Interoperability endpoints

  • Direct secure messaging: marcopalazzolo@newengurology.directglo.com
  • Direct secure messaging: marco.palazzolo.1@9808.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1467078006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 REVERE ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301251",
            "telephone_number": "978-317-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR STE 117T",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156183",
            "telephone_number": "978-232-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZOLO",
        "first_name": "MARCO",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2306719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.