Cosme Rolando Peccerelli, RPAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00178000 Issued in NJ

Practice address

22 Walmart PLZ
Clinton, NJ 08809

Phone

(908) 847-5272

NPI assigned

Dec 15, 2006

Last updated

Jul 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Luke's HospitalGroup PAC ID 0648189688, 100 clinicians

St. Luke's Hospital -Monroe CampusGroup PAC ID 1355637059, 53 clinicians

The Carbon-Schuylkill Community Hospital, Inc.Group PAC ID 4486562030, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

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.

• St. Luke's Hospital

  dba St. Luke's Care Now - Bethlehem

  • Urgent Care Clinic/Center
  • Bethlehem, PA
  • NPI 1740232719
  Medicare reassignment Care Compare group
• St. Luke's Hospital Monroe Campus

  • Occupational Medicine Physician
  • Stroudsburg, PA
  • NPI 1609311257
  Medicare reassignment Care Compare group
• The Carbon-Schuylkill Community Hospital, Inc.

  dba St. Luke's Miners Memorial Hospital ER

  • Emergency Medicine Physician
  • Coaldale, PA
  • NPI 1194891010
  Medicare reassignment Care Compare group
• GSL Hospital

  dba Geisinger St. Luke's Care Now Pottsville

  • Urgent Care Clinic/Center
  • Pottsville, PA
  • NPI 1073256608

  Emergency Medicine

  Medicare reassignment NPD
• St. Luke's Hosptial

  dba St. Luke's Care Now - Wind Gap

  • Urgent Care Clinic/Center
  • Wind Gap, PA
  • NPI 1376965731

  Emergency Medicine

  Medicare reassignment NPD
• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment
• St. Luke's Warren Physician Group, PC

  • Hematology & Oncology Physician
  • Phillipsburg, NJ
  • NPI 1467725184
  Medicare reassignment
• Atlantic Physician Services of Maryland, P.C.

  • Physician Assistant
  • Wilmington, DE
  • NPI 1730129594

  PA

  Medicare reassignment
• Gslpg, Inc

  • Specialist
  • Orwigsburg, PA
  • NPI 1366006702
  Medicare reassignment
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• St. Luke's Quakertown Hospital

  dba St. Luke's Quakertown Hospital - Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Quakertown, PA
  • NPI 1225052616
  Medicare reassignment
• St. Luke's Warren Physician Group, PC

  dba St. Luke's Warren Ophthalmology

  • Ophthalmology Physician
  • Phillipsburg, NJ
  • NPI 1568347201
  NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1487716361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-8046",
            "fax_number": "833-213-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WALMART PLZ",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "08809",
            "telephone_number": "908-847-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECCERELLI",
        "first_name": "COSME",
        "middle_name": "ROLANDO",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00178000",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "006232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishna Patel, M.D.
• Milan Patel, D.M.D.
• Pranav Patel, RPH
• Shea Patel, PA-C
• Paths Psychiatric Services, LLC
• Jennifer A Petrillo, M.D.
• Kelly Nicole Pflug, D.C.
• Podiatric Surgical Association of Central Jersey PA
• Jhansi Rani Poreddy
• Anne M. Porter, M.D.

• Physician Assistant in Clinton, NJ
• Providers in Clinton, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.