Active NPI
Richard Alan Pellegrini, M.D.
- Vascular & Interventional Radiology Physician
- Lexington, KY
National Provider Identifier
1952394140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 40306
- Practice address
- 800 Rose St # Hx307
Lexington, KY 40536-0293 - Phone
- (859) 323-5069
- Fax
- (859) 257-4457
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 000035462 | NC | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 40306 | KY | Primary |
Addresses
Primary practice location
800 Rose St # Hx307
Lexington, KY 40536-0293
Mailing address
800 Rose St # Hx307
Lexington, KY 40536-0293
Phone (859) 323-5069
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8966713 | Medicaid | NC | |
| 6412558600 | Medicaid | KY | |
| 66713 | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000035462 | NC | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1952394140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 ROSE ST # HX307",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360293",
"telephone_number": "859-323-5069",
"fax_number": "859-257-4457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 ROSE ST # HX307",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360293",
"telephone_number": "859-323-5069",
"fax_number": "859-257-4457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLEGRINI",
"first_name": "RICHARD",
"middle_name": "ALAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "000035462",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "KY",
"license": "40306",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8966713",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6412558600",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "66713",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.