Active NPI
Robert V Riccitelli, DPM
- Podiatrist
- Charlestown, MA
National Provider Identifier
1528049566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 2139
- Practice address
- 73 High St
CTN Charlestwon Healthcare Center
Charlestown, MA 02129-3096 - Phone
- (617) 724-2270
- Fax
- (617) 724-2070
- NPI assigned
- Nov 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 2139 | MA | Primary |
Addresses
Primary practice location
73 High St
CTN Charlestwon Healthcare Center
Charlestown, MA 02129-3096
Mailing address
PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 724-2270
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y71098 | Other | MA | BCBS MA |
| 0362310 | Medicaid | MA | |
| 403867 | Other | MA | TUFTS HEALTH PLAN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300 | RI | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Federal Hill Podiatry Group | Past | Accepting new patients | |
| Tollgate Chiropractic LTD | Past | Accepting new patients |
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.
-
- Foot & Ankle Surgery Podiatrist
- Providence, RI
- NPI 1194846154
-
- Chiropractor
- Warwick, RI
- NPI 1982909073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352851200000",
"number": "1528049566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9142",
"address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021299142",
"telephone_number": "617-724-2270",
"fax_number": "617-724-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73 HIGH ST",
"address_2": "CTN CHARLESTWON HEALTHCARE CENTER",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021293096",
"telephone_number": "617-724-2270",
"fax_number": "617-724-2070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCITELLI",
"first_name": "ROBERT",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2012-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MA",
"license": "2139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MA",
"identifier": "Y71098",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0362310",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "403867",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlestown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.