Individual provider Active NPI

Nicholas Louis Panetta, M.D.

  • Pulmonary Disease Physician
  • Wynnewood, PA
National Provider Identifier
1942464680
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD432897 Issued in PA
Practice address
100 E Lancaster Ave Ste 230
Wynnewood, PA 19096-3451
Phone
(610) 642-3796
Fax
(610) 642-2943
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD432897 PA
Pulmonary Disease Physician 207RP1001X MD432897 PA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD432897 PA
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD432897 PA

Addresses

Primary practice location

100 E Lancaster Ave Ste 230
Wynnewood, PA 19096-3451

Mailing address

100 E Lancaster Ave Ste 230
Wynnewood, PA 19096-3451
Phone (610) 642-3796

Other identifiers 3

IdentifierTypeStateIssuer
1007278000OtherPAMEDICAID TPI GROUP
CD4829OtherPARAILROAD MEDICARE TPI GROUP
597586OtherPAMEDICARE TPI GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120509000209 PA Practitioner - Pulmonary Disease 5698937662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonology Associates IncGroup PAC ID 5698757763, 18 clinicians

Practice addresses (Care Compare)

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (610) 648-0553

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD432897PAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonology Associates Inc Pulmonary Disease CurrentSince Dec 1, 2014 Accepting new patients
Main Line Healthcare Internal Medicine Past Accepting new patients

Locations

255 W Lancaster Ave
Ste 124
Paoli, PA 19301
Phone (610) 648-0553

100 E Lancaster Ave
Ste 230
Wynnewood, PA 19096
Phone (610) 642-3796

Interoperability endpoints

  • Direct secure messaging: nicholas.panetta@pai.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DJJDBA

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1942464680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 230",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963451",
            "telephone_number": "610-642-3796",
            "fax_number": "610-642-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 230",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963451",
            "telephone_number": "610-642-3796",
            "fax_number": "610-642-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANETTA",
        "first_name": "NICHOLAS",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD432897",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD432897",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD432897",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "PA",
            "license": "MD432897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID TPI GROUP",
            "identifier": "1007278000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE TPI GROUP",
            "identifier": "CD4829",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TPI GROUP",
            "identifier": "597586",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.