Andrew L Peredo, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

280821-1 Issued in NY

Practice address

110 E Main St Ste 6
Huntington, NY 11743-2845

Phone

(631) 424-3600

NPI assigned

Mar 28, 2011

Last updated

Jul 19, 2020By 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 3

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

Specialty

Plastic and Reconstructive Surgery

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andrew Peredo, MD, PCGroup PAC ID 7416321146, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
• NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Andrew Peredo, MD, PC

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1649980459
  Medicare reassignment Care Compare group NPD Authorized official
• Huntington Plastic Surgery PC

  • Plastic Surgery Physician
  • Melville, NY
  • NPI 1104286079
  Medicare reassignment NPD
• Skinfluence Medical PC

  • Specialist
  • New York, NY
  • NPI 1770963084
  Medicare reassignment NPD

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

• Central Suffolk Hospital

  dba Peconic Bay Homehealth Services

  • Home Health Agency
  • Riverhead, NY
  • NPI 1932155678
  Care Compare affiliation
• Huntington Hospital Association

  • General Acute Care Hospital
  • Huntington, NY
  • NPI 1508845322
  Care Compare affiliation

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595116800000",
    "number": "1043509227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST STE 6",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432845",
            "telephone_number": "631-424-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST STE 6",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432845",
            "telephone_number": "631-424-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook Medicine Department Of Surgery",
            "address_2": "Health Sciences Center T19-030",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948191",
            "country_code": "US",
            "telephone_number": "631-444-1791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "University of Colorado Plastic & Reconstructive Surgery",
            "address_2": "12631 East 17th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80045",
            "country_code": "US",
            "telephone_number": "303-724-2761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREDO",
        "first_name": "ANDREW",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2020-07-19",
        "certification_date": "2020-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "280821-1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "DR.0058741",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "280821-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Penzel, PH.D.
• Wendy R. Penzel, PSY.D.
• Gina Penzi Luxemberg, D.O.
• Carmelina Peralta, PHD
• Luz M Peralta, DNP
• Selwyn Jack Pereira, MD
• Jose M Perez, MD
• Alexander Perissi, PT
• Elizabeth Perlstein, PT
• Dennis Perman, D.C.

• Plastic Surgery Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.