Organization Active NPI

Peter M. Pasley, M.D., LLC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1083036685
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
217034 Issued in NY
Legal business name
PETER M. PASLEY, M.D., LLC
Practice address
1339 York Ave
New York, NY 10021-4707
Phone
(917) 656-3087
Fax
(973) 746-9231
NPI assigned
Jan 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Authorized official

Name
Dr. Peter M. Pasley, MDNPI 1104840503
Title
Owner
Phone
(917) 656-3087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 217034 NY Primary

Addresses

Primary practice location

1339 York Ave
New York, NY 10021-4707

Mailing address

21 Prescott Ave
Montclair, NJ 07042-5029
Phone (917) 656-3087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140325001235 NY Part B Supplier - Clinic/Group Practice 8628209244 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1083036685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PRESCOTT AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070425029",
            "telephone_number": "917-656-3087",
            "fax_number": "973-746-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214707",
            "telephone_number": "917-656-3087",
            "fax_number": "973-746-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER M. PASLEY, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "PASLEY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-656-3087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "217034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.