MS. DIANE PACKARD ANNIBALINI (PA-C) – Physician Assistant, NPI 1184956690
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. DIANE PACKARD ANNIBALINI (PA-C)
100 Hazard Ave
Suite 101
Enfield, CT 060825446
Phone: (860) 696-2380
Fax: (860) 745-3864
Type: Location
384, Merrow Road, Coventry, Tolland County, Connecticut, 06238, United States
TOLLAND, CT 060843970
Phone: (860) 871-8851
Fax: (860) 871-8852
Type: Location
O6, Saint Marc Circle, South Windsor, Capitol Planning Region, Connecticut, 06074, United States
SOUTH WINDSOR, CT 060744141
Phone: (860) 682-3950
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-02-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140214000903 | I | Physician Assistant | CT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 06082)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CT | |
| - | CT | |
| Physician Assistant | CT | |
| - | CT | |
| Family Practice | NY | |
| Physician Assistant | CT | |
| - | CT | |
| - | CT | |
| Internal Medicine, Geriatric Medicine | CT | |
| Nurse Practitioner | CT |
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