| Pinnacle Health Management, Llp | |
|
105 Webster St Suite 8 Hanover MA 02339-1227 | |
| (781) 754-6545 | |
| (781) 536-0016 |
| Full Name | Pinnacle Health Management, Llp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 105 Webster St, Hanover, Massachusetts |
| Authorized Official Name and Position | Gary C Phillips (MANAGING PARTNER) |
| Authorized Official Contact | 7817546545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinnacle Health Management, Llp 105 Webster St Suite 8 Hanover MA 02339-1227 Ph: (781) 754-6545 | Pinnacle Health Management, Llp 105 Webster St Suite 8 Hanover MA 02339-1227 Ph: (781) 754-6545 |
| NPI Number | 1952319733 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 04/13/2023 |
| Certification Date | 04/13/2023 |
| Medicare PECOS PAC ID | 7214974708 |
|---|---|
| Medicare Enrollment ID | O20050415000551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952319733 | NPI | - | NPPES |
| 110069689A | Medicaid | MA | |
| M19045 | Other | MA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Elizabeth H Nasser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497788582 PECOS PAC ID: 5799670824 Enrollment ID: I20040218000348 |
| Provider Name | Rogelio D Bayog |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487649208 PECOS PAC ID: 6901798156 Enrollment ID: I20040325000260 |
| Provider Name | Thomas W Stackhouse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124146121 PECOS PAC ID: 2961473293 Enrollment ID: I20040802001080 |
| Provider Name | Melinda A Gribko Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154563013 PECOS PAC ID: 4789646530 Enrollment ID: I20041103000357 |
| Provider Name | Rachel L Movitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497788491 PECOS PAC ID: 2567429368 Enrollment ID: I20041214000119 |
| Provider Name | Linda S Winiker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073690723 PECOS PAC ID: 6204860273 Enrollment ID: I20050920000978 |
| Provider Name | William F Zella |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750461109 PECOS PAC ID: 9032134838 Enrollment ID: I20051011000597 |
| Provider Name | Natalie K Rosenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861617433 PECOS PAC ID: 2466472949 Enrollment ID: I20051129000583 |
| Provider Name | Ruth M Soderberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043257637 PECOS PAC ID: 3577587997 Enrollment ID: I20060124000591 |
| Provider Name | Jan M Hutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336164870 PECOS PAC ID: 2961426226 Enrollment ID: I20060125000713 |
| Provider Name | Nancy M Perroni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306025705 PECOS PAC ID: 3870676000 Enrollment ID: I20080212000263 |
| Provider Name | Irina Dauphinee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417132259 PECOS PAC ID: 2961565791 Enrollment ID: I20090106000194 |
| Provider Name | Meredith B Detwiler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881834174 PECOS PAC ID: 6204993504 Enrollment ID: I20090331000209 |
| Provider Name | Marika R.g Taaffe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437272499 PECOS PAC ID: 7719038181 Enrollment ID: I20090624000494 |
| Provider Name | Ann M Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881627610 PECOS PAC ID: 3072559418 Enrollment ID: I20091030000152 |
| Provider Name | Kristen L Barletta |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1033404298 PECOS PAC ID: 9032382106 Enrollment ID: I20111105000011 |
| Provider Name | Kimberly Anne Reske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114263928 PECOS PAC ID: 3971758012 Enrollment ID: I20130221000398 |
| Provider Name | Lauren J Dargan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194009647 PECOS PAC ID: 3577797661 Enrollment ID: I20131003000056 |
| Provider Name | Iris J Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932452513 PECOS PAC ID: 4789909839 Enrollment ID: I20150211002002 |
| Provider Name | Kristen N Rondeau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528432366 PECOS PAC ID: 4789986092 Enrollment ID: I20160104001798 |
| Provider Name | Carolyn Loraine Cipolla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235640681 PECOS PAC ID: 9931475670 Enrollment ID: I20171024001931 |
| Provider Name | Elizabeth Kiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831447234 PECOS PAC ID: 9638406234 Enrollment ID: I20190805002609 |
| Provider Name | Mariah L Grispi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861034720 PECOS PAC ID: 4789017641 Enrollment ID: I20191206000575 |
| Provider Name | Sarinah Marie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346780145 PECOS PAC ID: 5890121024 Enrollment ID: I20200207000394 |
| Provider Name | Jessica L Dasilva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043857782 PECOS PAC ID: 1254761885 Enrollment ID: I20200423000530 |
| Provider Name | Kristina Gardiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881134195 PECOS PAC ID: 5597184861 Enrollment ID: I20201006001930 |
| Provider Name | Sarah Bevis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912507823 PECOS PAC ID: 4880094846 Enrollment ID: I20210611002120 |
| Provider Name | Antonio L Costa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609992916 PECOS PAC ID: 8729470968 Enrollment ID: I20220119002682 |
| Provider Name | Grace Onye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336517150 PECOS PAC ID: 1557730637 Enrollment ID: I20221212002622 |
| Provider Name | Chinyere Vivian Nwanesidu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922887173 PECOS PAC ID: 2264888163 Enrollment ID: I20231030001435 |
| Provider Name | Kimberly Ann Hudson Fahey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285802900 PECOS PAC ID: 0840641809 Enrollment ID: I20240104000783 |
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