Charissa Joy Pettyjohn, M.D.

Primary specialty

Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X

License

225481 Issued in MA

Practice address

750 Washington St.
Boston, MA 02111

Phone

(617) 636-0265

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Medical College of Wisconsin, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth OB-GYN, PCGroup PAC ID 5890885222, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pettyjohn.charissa.bwh@direct.partners.masshiway.net

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.

• Commonwealth OB-GYN, PC

  • Specialist
  • Brookline, MA
  • NPI 1912082694
  Medicare reassignment Care Compare group
• Brigham and Women'S Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD
• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  NPD (past)

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861614711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PEVERELL ST",
            "address_2": "APT 3",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02125",
            "telephone_number": "857-212-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-636-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTYJOHN",
        "first_name": "CHARISSA",
        "middle_name": "JOY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "MA",
            "license": "225481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea A Pettinato, MD
• Anthony Pettinato, MD, PHD
• Amy R. Pettit, PHD
• Rowland West Pettit, MD, PHD, MBA
• Patricia Ann Pettway, NP
• Rebecca Jean Peyev, CRNA
• James Matthew Peyton, MBCHB
• Jasmine Michelle Peyton
• Margo Ann Peyton, MD
• Fatemehsadat Pezeshkian, MD

• Obstetrics & Gynecology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.