Individual provider Active NPI

Peter J Pistilli, CPO

  • Prosthetist
  • Rochester, NY
National Provider Identifier
1639209992
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
CPO00981 Issued in NY
Practice address
1280 Scottsville Rd
Suite 50
Rochester, NY 14624-5147
Phone
(585) 436-7550
Fax
(585) 436-4022
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X CPO00981 NY
Prosthetist 224P00000X CPO00981 NY Primary

Addresses

Primary practice location

1280 Scottsville Rd
Suite 50
Rochester, NY 14624-5147

Mailing address

1280 Scottsville Rd
Suite 50
Rochester, NY 14624-5147
Phone (585) 436-7550

Other identifiers 1

IdentifierTypeStateIssuer
01459943MedicaidNY

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CPO00981NYMDOrthotist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Rochester Prosthetics & Orthotics Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1639209992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 SCOTTSVILLE RD",
            "address_2": "SUITE 50",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146245147",
            "telephone_number": "585-436-7550",
            "fax_number": "585-436-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 SCOTTSVILLE RD",
            "address_2": "SUITE 50",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146245147",
            "telephone_number": "585-436-7550",
            "fax_number": "585-436-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISTILLI",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NY",
            "license": "CPO00981",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NY",
            "license": "CPO00981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01459943",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.