Konstantoinos Petinos, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

171264 1 Issued in NY

Practice address

15849 84TH St
Howard Beach, NY 11414-3020

Phone

(718) 322-7425

Fax

(718) 322-5541

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: konstantoinospetinos@nslijmedgr.allscriptsdirect.net
• Direct secure messaging: konstantoinospetinos@qpc.allscriptsdirect.net

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

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023172285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 49 84TH STREET",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "11414",
            "telephone_number": "718-322-7425",
            "fax_number": "718-322-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15849 84TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143020",
            "telephone_number": "718-322-7425",
            "fax_number": "718-322-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETINOS",
        "first_name": "KONSTANTOINOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "171264 1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter F. Pelczar, M.D.
• Nicole Pellegrino, LMHC
• German Perez, PHARMD
• Maria Perfetto-Tullo, M.D.
• Michele Perris
• Heliana Phansalkar, OT
• Physicians Choice Surgicenter Inc
• Maria Rose Piazza
• Genevieve PO, PT
• Natalie Postelnek, MS; SAS

• Pediatrics Physician in Howard Beach, NY
• Providers in Howard Beach, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.