Individual provider Active NPI

William J Penhallurick, MD

  • Anesthesiology Physician
  • Westwood, MA
National Provider Identifier
1801893763
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
160569 Issued in MA
Practice address
690 Canton St
Suite 325
Westwood, MA 02090-2321
Phone
(781) 407-7713
Fax
(781) 407-0998
NPI assigned
Jul 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 160569 MA Primary

Addresses

Primary practice location

690 Canton St
Suite 325
Westwood, MA 02090-2321

Mailing address

690 Canton St
Suite 325
Westwood, MA 02090-2321
Phone (781) 407-7713

Other identifiers 1

IdentifierTypeStateIssuer
3202631MedicaidMA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100303000129 MA Practitioner - Anesthesiology 9638148463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York at Buffalo School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prima Care, PCGroup PAC ID 2567356017, 222 clinicians

Practice addresses (Care Compare)

277 Pleasant St
Suite 240
Fall River, MA 02721-3005
Phone (508) 676-3292

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Massachusetts LLC Anesthesiology CurrentSince Apr 1, 2018 Accepting new patients
Prima Care, PC CurrentSince Jun 1, 2019 Accepting new patients
Prima Care, PC CurrentSince Jun 1, 2019 Accepting new patients
Charlton Anesthesia Group, Inc. Anesthesiology PastSince Sep 29, 2004 Accepting new patients

Locations

277 Pleasant St
Fl 4
Fall River, MA 02721
Phone 50867632921244

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

277 Pleasant St
Ste 240
Fall River, MA 02721
Phone (500) 300-3271

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

300D Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 998-6683

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1801893763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902321",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902321",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENHALLURICK",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "160569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3202631",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, MA

Sources for this page

Verify at the official NPI Registry.