JOANMARIE DIETZ PELLEGRINI M.D.
NPI 1265402242
Surgery - Trauma Surgery in Bangor, ME

NPI Status: Active since January 24, 2006

Contact Information

360 BROADWAY
BANGOR, ME
ZIP 04401
Phone: (207) 907-3650
Fax: (207) 907-3660

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  • Individual
  • Female
  • Years of Experience 33
  • Surgery
  • Trauma Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOANMARIE PELLEGRINI

This page provides the complete NPI Profile along with additional information for Joanmarie Pellegrini, a provider established in Bangor, Maine with a medical specialization in Surgery, focusing in trauma surgery and more than 33 years of experience. She graduated from Tufts University School Of Medicine in 1993. The healthcare provider is registered in the NPI registry with number 1265402242 assigned on January 2006. The practitioner's primary taxonomy code is 2086S0127X with license number MD15414 (ME). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1265402242
Provider Name
JOANMARIE DIETZ PELLEGRINI M.D.
Gender
Female
Entity Type
Individual
Location Address
360 BROADWAY BANGOR, ME 04401
Location Phone
(207) 907-3650
Location Fax
(207) 907-3660
Mailing Address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT PO BOX 7291 LEWISTON, ME 04243
Mailing Phone
(207) 777-8560
Mailing Fax
(207) 907-3660
Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1993
Is Sole Proprietor?
No
Enumeration Date
01-24-2006
Last Update Date
02-03-2022
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Location Map

Secondary Locations

  • 489 State St
    Bangor, ME 04401
    (207) 973-7000
  • 70 East St
    Methuen, MA 01844
    (978) 956-3181

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Surgery Trauma Surgery

Taxonomy Code
2086S0127X
Type
Allopathic & Osteopathic Physicians
License No.
MD15414
License State
ME
Taxonomy Description
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208600000XAllopathic & Osteopathic Physicians

Surgery

036-138577 (IL)
2208600000XAllopathic & Osteopathic Physicians

Surgery

81948 (MA)
32086S0127XAllopathic & Osteopathic Physicians

Surgery
Trauma Surgery

81948 (MA)
42086S0127XAllopathic & Osteopathic Physicians

Surgery
Trauma Surgery

015414 (ME)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO
  • Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Texas Bronze HDHP 7500 - EPO
  • Moda Select Texas Standard Bronze - EPO
  • Moda Select Texas Standard Gold - EPO
  • Moda Select Texas Standard Silver - EPO
  • WellSense Clarity NH Bronze 6500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
  • WellSense Clarity NH Bronze 7500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
  • WellSense Clarity NH Bronze 7600 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
  • WellSense Clarity NH Gold 2000 + $0 Rx List + 24/7 Nurse Advice - HMO
  • WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice - HMO
  • WellSense Clarity NH Silver 3400 + $0 Rx List + 24/7 Nurse Advice - HMO
  • WellSense Clarity NH Silver 6000 + $0 Rx List + 24/7 Nurse Advice - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Joanmarie Pellegrini is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Joanmarie Pellegrini is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2668404898

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20050908000334, I20160120002365, I20221027003117

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    2 DME suppliers used 11 Medicare Claims 11 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 15 times for 11 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 24 times for 14 patients

Hernia repair - groin (open)

Hernia repair in the groin area (open) is a surgical procedure to fix a bulge or protrusion, caused by internal tissues pushing through a weak spot in your abdominal wall. In this operation, a small incision is made in the groin area. The protruding tissue is then placed back into the abdomen, and the weakened area is reinforced with stitches or a mesh.

This service was performed for 1-10 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 12 times for 12 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 11 times for 11 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Joanmarie Pellegrini is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST JOSEPH HOSPITAL360 BROADWAY
BANGOR, ME 04401
(207) 262-1000Acute Care Hospitals
ST JOSEPH HOSPITAL172 KINSLEY ST
NASHUA, NH 03060
(603) 882-3000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1265402242, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
2
Unchanged
Pos 9
4
Doubled → 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 2 → 4 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 8 + 0 + 4 + 2 + 8 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1265402242.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Hospitalist
360 BROADWAY
BANGOR, ME 04401
Hospitalist
360 BROADWAY
BANGOR, ME 04401
Physiological Laboratory
360 BROADWAY
BANGOR, ME 04401
Specialist
360 BROADWAY
BANGOR, ME 04401
Hospitalist
360 BROADWAY
BANGOR, ME 04401
Emergency Medicine
360 BROADWAY
BANGOR, ME 04401
Emergency Medicine
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Pharmacist
360 BROADWAY, PHARMACY DEPARTMENT
BANGOR, ME 04401
Registered Nurse
360 BROADWAY
BANGOR, ME 04401
Hospitalist
360 BROADWAY
BANGOR, ME 04401
General Acute Care Hospital
360 BROADWAY
BANGOR, ME 04401
Internal Medicine
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Pharmacist (Pharmacotherapy)
360 BROADWAY
BANGOR, ME 04401
Pharmacy Technician
360 BROADWAY
BANGOR, ME 04401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265402242, enumerated as an "individual" on January 24, 2006.

The provider is located at 360 BROADWAY BANGOR, ME 04401 and the phone number is (207) 907-3650.

Surgery with taxonomy code 2086S0127X and a focus in Trauma Surgery.

The provider might be accepting Accepts: Moda Health Plan, Inc. and WellSense Health Plan. Please consult your insurance carrier or call the provider to verify.

Joanmarie Pellegrini is affiliated with: ST JOSEPH HOSPITAL and ST JOSEPH HOSPITAL.