Individual provider Active NPI

Joshua Iannetta, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Scarborough, ME
National Provider Identifier
1508065210
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
1897 Issued in ME
Practice address
632 US Route 1
Scarborough, ME 04074-9794
Phone
(207) 883-1003
Fax
(207) 883-5322
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 1897 ME Primary

Addresses

Primary practice location

632 US Route 1
Scarborough, ME 04074-9794

Mailing address

632 US Route 1
Scarborough, ME 04074-9794
Phone (207) 883-1003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20070816000372 ME Practitioner - Osteopathic Manipulative Medicine 7618069931 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

632 US Route 1
Scarborough, ME 04074

Iannetta Osteopathic Manipulation
632 US Route 1
Scarborough, ME 04074
Phone (207) 883-1003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1897MEMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
University of New England Neuromusculoskeletal Medicine & Omm CurrentSince Jul 30, 2007 Accepting new patients
Webber Hospital Association CurrentSince Jan 3, 2012 Accepting new patients
University of New England CurrentSince Jul 30, 2007 Accepting new patients
Iannetta Manipulation LLC CurrentSince Dec 5, 2011 Accepting new patients
Mainehealth CurrentSince Jan 3, 2012 Accepting new patients
Iannetta Medical Services Inc PastSince Jun 1, 2009 Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

716 Stevens Ave
Portland, ME 04103
Phone (207) 221-4242

632 US Route 1
Scarborough, ME 04074
Phone (207) 883-1003

Interoperability endpoints

  • Direct secure messaging: jianetta@jlanetta.ssdirect.aprima.com

Organizations & group practices 7

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1508065210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749794",
            "telephone_number": "207-883-1003",
            "fax_number": "207-883-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749794",
            "telephone_number": "207-883-1003",
            "fax_number": "207-883-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNETTA",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "1897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.