Domenic Pisano, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS002998L Issued in PA

Practice address

196 W Sproul Rd
Suite 106
Springfield, PA 19064-2045

Phone

(610) 543-4000

Fax

(610) 543-4003

NPI assigned

Feb 14, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Imaging Professionals of Pennsylvania PC

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1952394363
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1669446159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST",
            "address_2": "3RD FLR.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "215-462-7100",
            "fax_number": "215-463-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 W SPROUL RD",
            "address_2": "SUITE 106",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642045",
            "telephone_number": "610-543-4000",
            "fax_number": "610-543-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANO",
        "first_name": "DOMENIC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS002998L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000751895",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liliana Cabrera Piccinini, AUD
• Gwenyth Pier-Goff
• Pioneers Consultants, PLLC
• Gina Piorkowski
• Thomas Piorkowski, O.D.
• Arthur A. Pluta, PAC
• Dana Mary Pomante
• Victoria Porretti, PT
• Kristyn Marie Powers, PHARM D
• Premier Orthopaedic and Sports Medicine Associates, LTD

• Cardiovascular Disease Physician in Springfield, PA
• Providers in Springfield, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.