William J Pezzello Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

008325 Issued in NY

Practice address

445 Lyceum Ave
Philadelphia, PA 19128-3420

Phone

(215) 508-5555

Fax

(215) 508-5554

NPI assigned

Jul 26, 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 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lyceum Longevity Center PLLC

  • Specialist
  • Philadelphia, PA
  • NPI 1831666585

  Chiropractor

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1720278740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 LYCEUM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283420",
            "telephone_number": "215-508-5555",
            "fax_number": "215-508-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 LYCEUM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283420",
            "telephone_number": "215-508-5555",
            "fax_number": "215-508-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZELLO",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "008325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "X6V741",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faith Pettyjohn, NP
• Adrian Meinrad Petzl, MD
• Halie Peveto, M.S. CCC-SLP
• Eliot Graham Peyster, MD
• Lia Rae Pezzato, MFT
• Kristen Pezzillo, MSPT, CWS
• Gino Vincenzo Pezzone
• Kimberly Ann Pfau, DO
• Jonathan Pfeffer, LCSW
• Jill A Pfeiffenberger, PHARMD

• Chiropractor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.