Active NPI
Jeffery Edward Piacitelli, PA-C
- Physician Assistant
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0002804
- Practice address
- 600 N Wolfe St
Baltimore, MD 21287-0005 - Phone
- (410) 955-5420
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0002804 | MD | Primary |
Addresses
Primary practice location
600 N Wolfe St
Baltimore, MD 21287-0005
Mailing address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-5420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080408000207 | UT | Practitioner - Physician Assistant | 4082791520 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879
2075 N 1200
Layton, UT 84041-1611
Phone (801) 779-6200
2075 University Park Blvd
Layton, UT 84041-1611
Phone (801) 387-6200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0002804 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
5063 S Cottonwood St
Salt Lake City, UT 84107
Phone (801) 507-1800
5171 S Cottonwood St
Ste 720
Salt Lake City, UT 84107
Phone (801) 507-3400
389 S 900 E
Slc, UT 84102
Phone (385) 282-2000
324 Tenth Ave
Ste 178
Slc, UT 84103
Phone (801) 321-2500
Organizations & group practices 4
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.
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- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972659530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-955-5420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-955-5420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIACITELLI",
"first_name": "JEFFERY",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0002804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- 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.