Patricia Pezzello, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

136277 Issued in NY

Practice address

1010 Northern Blvd
Suite 102
Great Neck, NY 11021-5306

Phone

(516) 487-8888

Fax

(516) 487-8887

NPI assigned

Jun 5, 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Optum Medical Care, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003

  Surgery

  Medicare reassignment NPD
• Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
  • NPI 1285975797
  Medicare reassignment NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Queens Long Island Medical Group, P.C.

  • Internal Medicine Physician
  • New York, NY
  • NPI 1891732038

  Surgery

  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1952340150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD",
            "address_2": "SUITE 102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215306",
            "telephone_number": "516-487-8888",
            "fax_number": "516-487-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD",
            "address_2": "SUITE 102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215306",
            "telephone_number": "516-487-8888",
            "fax_number": "516-487-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZELLO",
        "first_name": "PATRICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "136277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren B Peterson, ED.M.
• Elena Nicole Petkanas
• Tamara Jean Petrazzi, DPT
• Ashley Marie Petrillo
• Denise Petrizzi, NP
• Selena Phan, DPT
• Pharmacena LLC
• Pharmatopia Inc
• Huai Lee Phen, M.D
• Philip Ragone M D P C

• Surgery Physician in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.