JOHN PEDROTTY M.D.
NPI 1457344863
Family Medicine - Sports Medicine in Fall River, MA
NPI Status: Active since August 31, 2005
Contact Information
277 PLEASANT ST
SUITE 302
FALL RIVER, MA
ZIP 02721
Phone: (508) 672-1010
Fax: (508) 672-5077
- Individual
- Male
- Years of Experience 42
- Family Medicine
- Sports Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- CLIA Number: 22D0856644
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2026
About JOHN PEDROTTY
This page provides the complete NPI Profile along with additional information for John Pedrotty, a primary care provider established in Fall River, Massachusetts with a medical specialization in Family Medicine, focusing in sports medicine and more than 42 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 1984. The healthcare provider is registered in the NPI registry with number 1457344863 assigned on August 2005. The practitioner's primary taxonomy code is 207QS0010X with license number 58285 (MA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1457344863
- Provider Name
- JOHN PEDROTTY M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 277 PLEASANT ST SUITE 302 FALL RIVER, MA 02721
- Location Phone
- (508) 672-1010
- Location Fax
- (508) 672-5077
- Mailing Address
- 277 PLEASANT ST SUITE 302 FALL RIVER, MA 02721
- Mailing Phone
- (508) 672-1010
- Mailing Fax
- (508) 672-5077
- Medical School Name
- JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
- Graduation Year
- 1984
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-31-2005
- Last Update Date
- 02-25-2010
- Code Navigator
A primary care provider (PCP) like John Pedrotty sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
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
Family Medicine Sports Medicine
- Taxonomy Code
- 207QS0010X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 58285
- License State
- MA
- Taxonomy Description
- A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| R01139 | MEDICARE PIN (08) | ||
| B77247 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
John Pedrotty 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.
John Pedrotty 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: 4385600998
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: I20041206000729
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-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
8 DME suppliers used 35 Medicare Claims 57 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.
Annual depression screening, 15 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Bilirubin level, direct
Blood test, comprehensive group of blood chemicals
Blood test, lipids (cholesterol and triglycerides)
Blood test, thyroid stimulating hormone (tsh)
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Creatinine level to test for kidney function or muscle injury
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Hemoglobin a1c level
Initial nursing facility visit per day, typically 45 minutes
Insertion of needle into vein for collection of blood sample
Manual urinalysis test with examination using microscope, automated
Nursing facility annual assessment, typically 30 minutes
Prostate cancer screening; prostate specific antigen test (psa)
Thyroxine (thyroid chemical), free
Transitional care management services for problem of high complexity
Urine microalbumin (protein) level
Vitamin d-3 level
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
This service was performed 129 times for 129 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 129 times for 129 patientsA direct bilirubin test measures a form of bilirubin in your blood. Bilirubin is a substance produced during the normal breakdown of red blood cells. High levels may indicate liver or blood disorders. This test helps diagnose and monitor these conditions.
This service was performed 223 times for 128 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 222 times for 128 patientsA lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
This service was performed 227 times for 129 patientsA TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
This service was performed 96 times for 70 patientsA Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
This service was performed 164 times for 116 patientsA creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.
This service was performed 83 times for 49 patientsThis 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 101 times for 65 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 363 times for 147 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 22 times for 19 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 76 times for 45 patientsA follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
This service was performed 18 times for 14 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 142 times for 76 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 97 times for 81 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 275 times for 130 patientsA manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.
This service was performed 185 times for 116 patientsAn annual assessment at a nursing facility is a routine check-up that typically lasts about 30 minutes. It's a chance for healthcare professionals to evaluate your overall health and wellness, monitor any ongoing conditions, and adjust care plans as needed.
This service was performed 11 times for 11 patientsProstate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.
This service was performed 39 times for 39 patientsThe Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.
This service was performed 49 times for 44 patientsTransitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
This service was performed 12 times for 12 patientsThe urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.
This service was performed 83 times for 49 patientsA Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.
This service was performed 115 times for 88 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.67 for a new patient copayment and $25.87 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 02721 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.7
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.67
- Minimum New Patient Copayment $14.71
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $103.48
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $25.87
- Minimum Established Patient Copayment $4.77
- Maximum Established Patient Copayment $36.21
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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. John Pedrotty is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| SAINT ANNE'S HOSPITAL | 795 MIDDLE STREET FALL RIVER, MA 02721 | (508) 674-5600 | Acute Care Hospitals | |
| SOUTHCOAST HOSPITALS GROUP | 363 HIGHLAND AVENUE FALL RIVER, MA 02720 | (508) 679-3131 | Acute Care Hospitals |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 22D0856644
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- JOHN C. PEDROTTY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to John Pedrotty to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 5 | 7 | 3 | 4 | 4 | 8 | 6 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 10 | 7 | 6 | 4 | 8 | 8 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 0 + 7 + 6 + 4 + 8 + 8 + 1 + 2 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1457344863 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. NEVEEN N. BASSALY M.D.
Internal Medicine
277 PLEASANT ST
STE 307
FALL RIVER, MA
ZIP 02721
LINSEY PHILIP M.D.
Internal Medicine
(Infectious Disease)
277 PLEASANT ST
SUITE 306
FALL RIVER, MA
ZIP 02721
EHAB SORIAL M.D.
Internal Medicine
277 PLEASANT ST
SUITE 209
FALL RIVER, MA
ZIP 02721
JANE SARAIVA CAMARA N.P.
Nurse Practitioner
277 PLEASANT ST
SUITE 209
FALL RIVER, MA
ZIP 02721
DR. DEBBIE-ANN L TAN M.D.
Internal Medicine
277 PLEASANT ST
PRIMA CARE, PC
FALL RIVER, MA
ZIP 02721
NATANAEL CORDEIRO
Physician Assistant
277 PLEASANT ST
SUITE 203
FALL RIVER, MA
ZIP 02721
ANA COJOCARU M.D.
Internal Medicine
(Pulmonary Disease)
277 PLEASANT ST
PRIMA CARE MEDICAL
FALL RIVER, MA
ZIP 02721
BRENDA N ROY MD
Obstetrics & Gynecology
277 PLEASANT ST
SUITE 203
FALL RIVER, MA
ZIP 02721
MAHMOOD AHMAD M.D
Internal Medicine
277 PLEASANT ST
4TH FLOOR
FALL RIVER, MA
ZIP 02721
MS. RICHA MAGAN PA-C
Physician Assistant
277 PLEASANT ST
SUITE 202
FALL RIVER, MA
ZIP 02721
PAUL I BULAT MD
Emergency Medicine
277 PLEASANT ST
PRIMA CARE, PC
FALL RIVER, MA
ZIP 02721
PRIMA CARE WELLNESS CENTER
Family Medicine
277 PLEASANT ST
SUITE 309
FALL RIVER, MA
ZIP 02721
MRS. JENNIFER GILLIS N.P.
Nurse Practitioner
(Adult Health)
277 PLEASANT ST
STE. 309
FALL RIVER, MA
ZIP 02721
DR. JUAN CARLOS MENDIETA HERNANDEZ M.D.
Internal Medicine
(Cardiovascular Disease)
277 PLEASANT ST
FALL RIVER, MA
ZIP 02721
JEFFREY J. STEINBERG M.D.
Psychiatry & Neurology
(Neurology)
277 PLEASANT ST
FALL RIVER, MA
ZIP 02721
MARK S SISKIND MD
Internal Medicine
(Nephrology)
277 PLEASANT ST
STE 305
FALL RIVER, MA
ZIP 02721
MR. KEITH D TURCOTTE NP
Nurse Practitioner
277 PLEASANT ST
FALL RIVER, MA
ZIP 02721
DR. XIAODAN WANG MD
Internal Medicine
(Infectious Disease)
277 PLEASANT ST
PRIMA CARE
FALL RIVER, MA
ZIP 02721
HEIDI MARTINS N.P.
Nurse Practitioner
(Adult Health)
277 PLEASANT ST
FALL RIVER, MA
ZIP 02721
DR. AUDBERTO CESAR ANTONINI GONZALEZ M.D.
Internal Medicine
277 PLEASANT ST
FALL RIVER, MA
ZIP 02721
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457344863, enumerated as an "individual" on August 31, 2005.
The provider is located at 277 PLEASANT ST SUITE 302 FALL RIVER, MA 02721 and the phone number is (508) 672-1010.
Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
John Pedrotty is affiliated with: SAINT ANNE'S HOSPITAL and SOUTHCOAST HOSPITALS GROUP.
