Individual provider Active NPI

Xiangmin Peng, MD

  • Neurology Physician
  • West Nyack, NY
National Provider Identifier
1013235340
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
275128 Issued in NY
Practice address
2 Centerock Rd
West Nyack, NY 10994-2215
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 275128 NY Primary

Addresses

Primary practice location

2 Centerock Rd
West Nyack, NY 10994-2215

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address xiangmin.pengmd.p1@direct.crystalrun.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150811004734 NY Practitioner - Neurology 4284949868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crystal Run Healthcare Physicians LLPGroup PAC ID 6901792696, 366 clinicians

Practice addresses (Care Compare)

300 Crystal Run Rd
Middletown, NY 10941-4069
Phone (845) 692-6999

Hospital & facility affiliations

  • Helen Hayes Hospital Hospital, West Haverstraw, NY, CCN 330405

Merit-based Incentive Payment System (MIPS)

Final score
85.01 of 100Reported as group
Quality
73.63
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
275128NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Run Healthcare Physicians LLP CurrentSince Aug 3, 2015 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Aug 3, 2015 Accepting new patients

Locations

155 Crystal Run Rd
Middletown, NY 10941

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

2 Centerock Rd
West Nyack, NY 10994
Phone (844) 592-7009

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1013235340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CENTEROCK RD",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942215",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "XIANGMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "275128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "xiangmin.pengmd.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2 Centerock Rd",
            "city": "West Nyack",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109942215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.