Michael J Pisano III, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS007441L Issued in PA

Practice address

1626 E Passyunk Ave
Philadelphia, PA 19148-1122

Phone

(215) 467-0700

Fax

(215) 467-4457

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Passyunk Medical Associates PC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1851332589
  Authorized official Same address or phone

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1538103924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481122",
            "telephone_number": "215-467-0700",
            "fax_number": "215-467-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 E PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481122",
            "telephone_number": "215-467-0700",
            "fax_number": "215-467-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS007441L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014422590002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Pirrone
• Jason Lee Pirrung, LCSW
• Michael A Pisa, CRNP
• Amy Pisanchyn, CRNP
• Alessio Pisano, LPC, ACS, NCC
• Thomas John Pisano, MD
• Katherine Piselli, PH.D.
• Allyson Marie Pishko
• Glenn Howard Pisk, M.D.
• John Edward Piskai, DDS

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.