Provider Demographics
NPI:1144294273
Name:PACIFICO, LUIGI (DO)
Entity type:Individual
Prefix:
First Name:LUIGI
Middle Name:
Last Name:PACIFICO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-3130
Mailing Address - Fax:508-368-3133
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 290 N
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-368-3130
Practice Address - Fax:508-368-3133
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71660207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherONE HEALTH PLAN
26916OtherCHILDRENS MED SECURITY
1061138OtherFIRST HEALTH
J16208OtherBLUE SHIELD INDEMNITY
043058466OtherHEALTHCARE VALUE MGMT
3142558OtherMEDICAID WELFARE
991143OtherFALLON COMMUNITY HEALTH
MA3142558Medicaid
784062OtherMVP HEALTH CARE
A20386OtherMEDICARE B
J16208OtherBLUE SHIELD HMO BLUE
26916OtherHEALTHY START
J16208OtherBLUE CARE ELECT
2500247OtherEVERCARE
3137201OtherMEDICAID PCC
AA2840OtherHARVARD PILGRIM
5432660OtherAETNA US HEALTHCARE
5818752OtherCIGNA HEALTH PLAN
A20386OtherMEDICARE B
MA3142558Medicaid