Individual provider Active NPI

Nicholas Peter Pacella, M.D.

  • Pediatrics Physician
  • Worcester, MA
National Provider Identifier
1487601068
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
76181 Issued in MA
Practice address
45 Oak Ave
Worcester, MA 01605-2730
Phone
(508) 756-2020
Fax
(508) 756-0705
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 76181 MA Primary

Addresses

Primary practice location

45 Oak Ave
Worcester, MA 01605-2730

Mailing address

45 Oak Ave
Worcester, MA 01605-2730
Phone (508) 756-2020

Other identifiers 1

IdentifierTypeStateIssuer
3104907MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76181MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southboro Medical Group, Inc. Pediatrics Past Accepting new patients
Ian a. Harding MD PC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nicholas.pacella.1@12826.direct.athenahealth.com

Organizations & group practices 2

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1487601068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 OAK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052730",
            "telephone_number": "508-756-2020",
            "fax_number": "508-756-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 OAK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052730",
            "telephone_number": "508-756-2020",
            "fax_number": "508-756-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACELLA",
        "first_name": "NICHOLAS",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "76181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3104907",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.