John Albert Pezzullo III, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD10244 Issued in RI

Practice address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Phone

(401) 432-2520

Fax

(401) 453-8220

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Enrolled in RI, MA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Geisel School of Medicine at Dartmouth, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rhode Island Medical Imaging IncGroup PAC ID 8022097815, shared by 2 NPIs, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rhode Island Hospital Hospital, Providence, RI, CCN 410007
• Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008
• Roger Williams Medical Center Hospital, Providence, RI, CCN 410004
• The Miriam Hospital Hospital, Providence, RI, CCN 410012
• Newport Hospital Hospital, Newport, RI, CCN 410006

Merit-based Incentive Payment System (MIPS)

Final score

86.17 of 100Reported as group

Quality

82.44

Improvement activities

40

Cost

86.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpezzullo12016@brownhealth.medalliesdirect.net

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.

• Rhode Island Medical Imaging Inc

  • Diagnostic Radiology Physician
  • Warwick, RI
  • NPI 1205874930
  Medicare reassignment NPD
• Rhode Island Medical Imaging Inc

  • Diagnostic Radiology Physician
  • Providence, RI
  • NPI 1942376033

  MA

  Medicare reassignment NPD
• Lifespan Corporation

  • Children's Rehabilitation Hospital
  • Providence, RI
  • NPI 1790221232
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Newport Hospital

  • General Acute Care Hospital
  • Newport, RI
  • NPI 1457346413
  Care Compare affiliation
• Prospect Chartercare RWMC, LLC

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014
  Care Compare affiliation
• Rhode Island Hospital

  • Ambulance
  • Providence, RI
  • NPI 1053552299

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • Clinic/Center
  • Providence, RI
  • NPI 1154663383

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  Care Compare affiliation
• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation
• Sturdy Memorial Hospital Inc

  • General Acute Care Hospital
  • Attleboro, MA
  • NPI 1730106162
  Care Compare affiliation

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1528056496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZULLO",
        "first_name": "JOHN",
        "middle_name": "ALBERT",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "212505",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "10244",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD10244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "007008119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROADMEDICARE",
            "identifier": "300108647",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHHCS",
            "identifier": "9102814",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL PIN",
            "identifier": "007008121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHPLANS",
            "identifier": "1600094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRI",
            "identifier": "0000000001988",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIMEDICALASSISTANCE",
            "identifier": "7008119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "720099401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "010244",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MED ASSISTANCE",
            "identifier": "003117117",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSMEDICAID",
            "identifier": "3208486",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "010244",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIHPILGRIM",
            "identifier": "241272",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYSTART",
            "identifier": "3208486",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHIP",
            "identifier": "407649",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chantele Petrocelli, LMHC
• Petteruti Family Practice Inc
• Shannon Petteruti, NP-C
• Kaitlin M Petty
• Bethany A Pezza, NP
• Robert A Pezzullo, COTA
• Catherine B Phamduy
• Pharmacy Corporation of America
• Melissa Phelps, LICSW
• Kathleen M Phillips, MS RNP

• Diagnostic Radiology Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Diagnostic Radiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.