Individual provider Active NPI

Peter Joseph Pimpinelli, PA-C

  • Physician Assistant
  • Morristown, NJ
National Provider Identifier
1871903880
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00357800 Issued in NJ
Practice address
55 Madison Ave FL 2
Morristown, NJ 07960-7337
Phone
(973) 971-4340
Fax
(973) 290-7367
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00357800 NJ Primary
Physician Assistant 363A00000X 018366-1 NY

Addresses

Primary practice location

55 Madison Ave FL 2
Morristown, NJ 07960-7337

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other practice location 1

11 Overlook Rd Ste 230
Summit, NJ 07901-3580
Phone (908) 522-6619

Other practice location 2

194 Hwy 31
Flemington, NJ 08822-5793
Phone (973) 971-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20150302000948 NJ Practitioner - Physician Assistant 7012233489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00357800NJMDPhysician Assistant
018366-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Kids Pediatrics, LLC PastSince Jun 14, 2020 Accepting new patients
BCD Health Partners Past Accepting new patients

Organizations & group practices 3

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": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1871903880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MADISON AVE FL 2",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607337",
            "telephone_number": "973-971-4340",
            "fax_number": "973-290-7367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Overlook Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079013580",
            "country_code": "US",
            "telephone_number": "908-522-6619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "194 Hwy 31",
            "address_purpose": "LOCATION",
            "city": "Flemington",
            "state": "NJ",
            "postal_code": "088225793",
            "country_code": "US",
            "telephone_number": "973-971-4340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIMPINELLI",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00357800",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018366-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.