NPIMap

Individual provider Active NPI

John Petolillo Jr., DO

  • Orthopaedic Surgery Physician
  • Langhorne, PA
National Provider Identifier
1780684084
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS008198L Issued in PA
Practice address
240 Middletown Blvd
Suite 101D
Langhorne, PA 19047-1832
Phone
(215) 750-6700
Fax
(215) 750-6700
NPI assigned
Jul 28, 2005
Last updated
Apr 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS008198L PA Primary

Addresses

Primary practice location

240 Middletown Blvd
Suite 101D
Langhorne, PA 19047-1832

Mailing address

240 Middletown Blvd
Suite 101D
Langhorne, PA 19047-1832
Phone (215) 750-6700

Other identifiers 1

IdentifierTypeStateIssuer
200044351OtherPATRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040707001242 PA Practitioner - Orthopedic Surgery 8123005113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Philadelphia College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health OrthopaedicsGroup PAC ID 2365695251, 18 clinicians

Practice addresses (Care Compare)

380 N Oxford Valley Rd
FL 1
Langhorne, PA 19047-8304
Phone (215) 409-9300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement81
Knee replacement57

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Oct 1, 2018 Accepting new patients
Aria Health Physician Services CurrentSince Oct 1, 2018 Accepting new patients
Aria Health Orthopaedics Orthopaedic Surgery CurrentSince Aug 1, 2014 Accepting new patients
Aria Health Physician Services Current Accepting new patients

Locations

240 Middletown Blvd
Ste 101D
Langhorne, PA 19047
Phone (215) 702-0600

380 N Oxford Valley Rd
Fl 1
Langhorne, PA 19047
Phone (215) 757-3980

380 N Oxford Valley Rd
Fl First
Langhorne, PA 19047
Phone (215) 949-5024

3998 Red Lion Rd
Ste 235
Philadelphia, PA 19114
Phone (215) 632-3630

Organizations & group practices 5

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 12

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

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1780684084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MIDDLETOWN BLVD",
            "address_2": "SUITE 101D",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471832",
            "telephone_number": "215-750-6700",
            "fax_number": "215-750-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MIDDLETOWN BLVD",
            "address_2": "SUITE 101D",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471832",
            "telephone_number": "215-750-6700",
            "fax_number": "215-750-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETOLILLO",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OS008198L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "200044351",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.