Damon John Pettinelli, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D0058950 Issued in MD

Practice address

6231 N Charles St
Baltimore, MD 21212-1113

Phone

(410) 377-2044

Fax

(410) 377-8061

NPI assigned

Aug 22, 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Ophthalmology

Education

Temple University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Eye Surgery Associates PLLCGroup PAC ID 6800785148, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.97 of 100Reported as group

Quality

100

Improvement activities

40

Cost

79.89

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

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.

• New York Eye Surgery Associates PLLC

  • Specialist
  • Bronx, NY
  • NPI 1699873067
  Medicare reassignment Care Compare group NPD
• Ambulatory Surgery Center of Greater New York, LLC

  • Ambulatory Surgical Clinic/Center
  • Bronx, NY
  • NPI 1376641670
  NPD (past)
• Manhattan Eye Ear and Throat Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1922169689
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558477448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8618 EASTERN MORNING RUN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235865",
            "telephone_number": "301-317-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6231 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121113",
            "telephone_number": "410-377-2044",
            "fax_number": "410-377-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINELLI",
        "first_name": "DAMON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0058950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Pettaway
• Brittany N Petteway, MS, OTR/L
• Latashia N Pettiford, CAC-AD
• Tara Marcell Pettiford
• Emma Pettinati
• Jessica Pettit
• Ruby Pettway
• Brent G Petty, M.D.
• Laura Ann Petza
• Sara Peuster, ATC

• Ophthalmology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.