Philip Flemming Pacelli III, MD DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

007900 Issued in CT

Practice address

166 Cherry Street
Suite a
New Canaan, CT 06840

Phone

(203) 972-1581

Fax

(203) 972-1980

NPI assigned

Mar 20, 2007

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 6, 2016 through Oct 6, 2026

Specialty

Maxillofacial Surgery

Education

Hahnemann University College of Medicine, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1699890723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 CHERRY STREET",
            "address_2": "SUITE A",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "06840",
            "telephone_number": "203-972-1581",
            "fax_number": "203-972-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 CHERRY STREET",
            "address_2": "SUITE A",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "06840",
            "telephone_number": "203-972-1581",
            "fax_number": "203-972-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACELLI",
        "first_name": "PHILIP",
        "middle_name": "FLEMMING",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CT",
            "license": "007900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "CV2783",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2552103",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "020007900CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ordonez, LCSW
• Evan Ormond, LCSW
• Orthoconnecticut, PC
• Orthopaedic Surgery & Sports Medicine Center Inc
• Ashley Pacelli
• Todd Robert Palker, MD
• Junghee Park
• Aesha S Patel, DO
• Divya Patel
• Joan Pehta, M.D.

• Oral & Maxillofacial Surgery (D.M.D.) in New Canaan, CT
• Providers in New Canaan, CT by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; 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; Opt Out Affidavits.
• 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.