Individual provider Active NPI

Christopher Robert Panetta, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1538311220
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
012880 Issued in NY
Practice address
100E 77TH St
New York, NY 10021
Phone
(212) 434-2000
NPI assigned
Oct 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 012880 NY Primary

Addresses

Primary practice location

100E 77TH St
New York, NY 10021

Mailing address

100E 77TH St
New York, NY 10021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925001430 CT Practitioner - Physician Assistant 6103089644 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

2800 Main St
Bridgeport, CT 06606-4201

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012880NYMDClinical Psychologist
3349CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Nov 5, 2019 Accepting new patients
University of Connecticut Health Center CurrentSince Nov 5, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Surgical CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Sep 1, 2015 Accepting new patients

Locations

5 Munson Rd
Farmington, CT 06032
Phone (860) 679-4888

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: christopher.panetta@xdr.hhchealthdirect.org

Organizations & group practices 5

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 2

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": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1538311220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-434-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANETTA",
        "first_name": "CHRISTOPHER",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "012880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.