Individual provider Active NPI

Adriana Dietz Pellegrini, DO

  • Surgery Physician
  • Johnstown, PA
National Provider Identifier
1700579950
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OT022426 Issued in PA
Practice address
1086 Franklin St
Johnstown, PA 15905-4305
Phone
(814) 534-1660
Fax
(814) 534-1680
NPI assigned
Jun 1, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OT022426 PA Primary

Addresses

Primary practice location

1086 Franklin St
Johnstown, PA 15905-4305

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-1660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20230823000198 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 1951764083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT022426PAMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: apellegrini48626@direct.conemaugh.org

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1700579950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-534-1660",
            "fax_number": "814-534-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-534-1660",
            "fax_number": "814-534-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "ADRIANA",
        "middle_name": "DIETZ",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OT022426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.