MEDICARE: DR. JOHN N PANDISCIO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0044953	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0074053002	OTHER	MA	CIGNA
2	4692	OTHER	MA	FALLON
3	2000000364	OTHER	MA	HARVID PILGRIM HEALTH CAR
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	709859	OTHER	MA	TUFTS HEALTH PLAN
6	0102037	OTHER	MA	UNITED HEALTHCARE
7	J04562	OTHER	MA	BLUE CROSS& BLUE SHIELD

General Provider Information

NPI Number	:	1740286715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN N PANDISCIO M.D.

Provider Business Mailing Address
First Line	:	169 W MAIN ST
Second Line	:
City	:	HOPKINTON
State	:	MA
Zip	:	01748-2175
Country	:	US
Telephone Number	:	508-435-6903
Fax Number	:	508-435-2311

Provider Business Practice Location Address
First Line	:	169 W MAIN ST
Second Line	:
City	:	HOPKINTON
State	:	MA
Zip	:	01748-2175
Country	:	US
Telephone Number	:	508-435-6903
Fax Number	:	508-435-2311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	03/07/2023

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Directions to “ DR. JOHN N PANDISCIO M.D.” Practice Location

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