Active NPI
Russell James Pepe, MD
- General Practice Physician
- New Hyde Park, NY
National Provider Identifier
1043849706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 324291
- Practice address
- 27005 76TH Ave
New Hyde Park, NY 11040-1402 - Phone
- (718) 470-4475
- Fax
- (718) 962-2239
- NPI assigned
- Apr 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 324291 | NY | Primary |
Addresses
Primary practice location
27005 76TH Ave
New Hyde Park, NY 11040-1402
Mailing address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-4475
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 324291 | NY | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Essen Medical Associates, PC | Current | Accepting new patients | |
| Essen Medical Associates, PC | Current | Accepting new patients | |
| Essen Medical Urgicare, PLLC | Current | Accepting new patients |
Locations
2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400
1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366
8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207
8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400
Organizations & group practices 3
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.
-
- Legal Medicine
- Bronx, NY
- NPI 1366418709
-
- Urgent Care Clinic/Center
- Bronx, NY
- NPI 1841607298
-
- Podiatrist
- Bronx, NY
- NPI 1720799158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1043849706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27005 76TH AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401402",
"telephone_number": "718-470-4475",
"fax_number": "718-962-2239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27005 76TH AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401402",
"telephone_number": "718-470-4475",
"fax_number": "718-962-2239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEPE",
"first_name": "RUSSELL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-05",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "324291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.