Daivyd Alexander Palencia Pacheco, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

BP10065359 Issued in CT

Practice address

56 Franklin St Ste 1
Waterbury, CT 06706-1281

Phone

(203) 709-6479

NPI assigned

Jun 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: dpalenciapacheco1357174@nychhc.direct-ci.com
• Direct secure messaging: daivyd.palencia-pacheco@xdr.hhchealthdirect.org

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.

• Saint Mary'S Hospital, Inc.

  • Student in an Organized Health Care Education/Training Program
  • Waterbury, CT
  • NPI 1235702762
  NPD (past)
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1740775394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR # 7742",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293900",
            "telephone_number": "210-567-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST STE 1",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061281",
            "telephone_number": "203-709-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALENCIA PACHECO",
        "first_name": "DAIVYD",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10065359",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "BP10065359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pain & Spine Specialists of Connecticut, LLC
• Pain & Spine Specialists of Connecticut, LLC
• Pain Management Partners LLC
• Mary Painter, LCSW
• Reza Pakdaman, M.D.
• J. Alexander Palesty, MD
• Alyson Paliwoda, DPT
• Todd Joseph Palladino, OTR/L, CLT
• James Palmer
• Kelly Lynn Palmer, OTR

• Student in an Organized Health Care Education/Training Program in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.