John Richard Pettinato, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

152555 Issued in MA

Practice address

46 Obery St
Plymouth, MA 02360-2237

Phone

(508) 210-5920

Fax

(508) 732-8935

NPI assigned

Oct 11, 2006

Last updated

Feb 24, 2020By the provider in NPPES

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 MA

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

Specialty

Neurology

Education

Chicago College of Osteopathy, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpettinato254514@direct.bilh.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131
  Medicare reassignment Care Compare group NPD
• Jordan Physician Associates, Inc.

  dba BIDH-Plymouth Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1730277914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-210-5920",
            "fax_number": "508-732-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-210-5920",
            "fax_number": "508-732-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINATO",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "152555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30221273",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Petitpas, LMHC
• Janet Elizabeth Petrella, L.I.C.S.W.
• Kayla A Petrie, BCBA
• Jeffry Petrosevich
• Curtis James Petruzzelli, MD
• Iris Mae Pevzner, RBT
• Mark Pham, D.M.D.
• Peter Tan Phan, D.M.D.
• Joseph D Phelan, CRNA
• Elliot Ramie Philie

• Neurology Physician in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.
• 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.