NPIMap

Individual provider Active NPI

Brian Thomas Pellicano, PA

  • Physician Assistant
  • Springfield, MA
National Provider Identifier
1497395842
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA102074 Issued in MA
Practice address
300 Birnie Ave Ste 201
Springfield, MA 01107-1121
Phone
(413) 785-4666
Fax
(413) 846-4756
NPI assigned
Jan 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA102074 MA Primary

Addresses

Primary practice location

300 Birnie Ave Ste 201
Springfield, MA 01107-1121

Mailing address

300 Birnie Ave Ste 201
Springfield, MA 01107-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210329001754 NH Practitioner - Physician Assistant 9931516481 Reassigns benefits to 3 organizations
I20251209002121 MA Practitioner - Physician Assistant 9931516481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Cheshire Medical CenterGroup PAC ID 1456260165, 165 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

300 Birnie Ave
Suite 201
Springfield, MA 01107-1121
Phone (714) 785-4666

580 Court St
Keene, NH 03431-1718
Phone (603) 354-5454

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
75.44
Promoting interoperability
100
Improvement activities
40
Cost
72.09

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1690NHMDDentist
PA102074MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 15, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince May 2, 2021 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Dec 26, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince May 2, 2021 Accepting new patients
Cheshire Medical Center CurrentSince May 2, 2021 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Dec 26, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 15, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince May 2, 2021 Accepting new patients
Mary Hitchcock Memorial Hospital Past Accepting new patients

Locations

265 Benton Dr
Ste 101
East Longmeadow, MA 01028
Phone (714) 785-4666

325B King St
Ste 101
Northampton, MA 01060

300 Birnie Ave
Ste 201
Springfield, MA 01107
Phone (413) 233-1292

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: bpellicano424275@direct.dartmouth-hitchcock.org

Organizations & group practices 9

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 7

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1497395842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE STE 201",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE STE 201",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071121",
            "telephone_number": "413-785-4666",
            "fax_number": "413-846-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICANO",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA102074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.