Shelley Penna, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

264644 Issued in MA

Practice address

1 Park Way
Haverhill, MA 01830-6278

Phone

(978) 521-3270

Fax

(978) 469-5320

NPI assigned

Aug 8, 2006

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermphysicians of New England LLCGroup PAC ID 0749522969, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winchester Hospital Hospital, Winchester, MA, CCN 220105

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Dermphysicians of New England LLC

  • Dermatology Physician
  • Burlington, MA
  • NPI 1558834523
  Medicare reassignment Care Compare group

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

• Winchester Hospital

  • General Acute Care Hospital
  • Winchester, MA
  • NPI 1790740777
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1831109602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "781-779-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK WAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306278",
            "telephone_number": "978-521-3270",
            "fax_number": "978-469-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNA",
        "first_name": "SHELLEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "264644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NP5445",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Pellegrini, MSW
• Gianna Pellegrino
• Chloe Pelletier, DPT
• Sarah Jean Pelletier, MSW, LICSW
• Penacook Place, Inc.
• Pentucket Medical Associates LLC
• Pentucket Medical Associates, LLC
• Pentucket Medical Radiology
• Carmen Pepicelli
• Holly Anne Pereira

• Family Nurse Practitioner in Haverhill, MA
• Providers in Haverhill, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.
• 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.