NPIMap

Individual provider Active NPI

Peter John Pitocchi, M.D.

  • Internal Medicine Physician
  • Orange Park, FL
National Provider Identifier
1750397519
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0062014 Issued in FL
Practice address
1555 Kingsley Ave
Suite 501
Orange Park, FL 32073-4560
Phone
(904) 264-2402
NPI assigned
Aug 1, 2006
Last updated
Oct 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0062014 FL Primary

Addresses

Primary practice location

1555 Kingsley Ave
Suite 501
Orange Park, FL 32073-4560

Mailing address

1555 Kingsley Ave
Suite 501
Orange Park, FL 32073-4560
Phone (904) 264-2402

Other identifiers 1

IdentifierTypeStateIssuer
370168900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617001751 FL Practitioner - Internal Medicine 5597749259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Florida College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1555 Kingsley Ave
Suite 501
Orange Park, FL 32073-9207

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0062014FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter J. Pitocchi MD PA Internal Medicine CurrentSince Oct 1, 2003 Accepting new patients
St Vincents Ambulatory Care Inc Internal Medicine Past Accepting new patients

Locations

1555 Kingsley Ave
Ste 501
Orange Park, FL 32073
Phone (904) 264-2402

Organizations & group practices 2

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1750397519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE",
            "address_2": "SUITE 501",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734560",
            "telephone_number": "904-264-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE",
            "address_2": "SUITE 501",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734560",
            "telephone_number": "904-264-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITOCCHI",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0062014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370168900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.