Individual provider Active NPI

Patricia Eillen Palos

  • Obstetrics & Gynecology Physician
  • Greenwich, CT
National Provider Identifier
1083858682
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
054416 Issued in CT
Practice address
2 1/2 Dearfield Dr
Suite 101
Greenwich, CT 06831-5335
Phone
(203) 861-9586
Fax
(203) 861-9587
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 69687 GA
Obstetrics & Gynecology Physician 207V00000X 054416 CT Primary

Addresses

Primary practice location

2 1/2 Dearfield Dr
Suite 101
Greenwich, CT 06831-5335

Mailing address

2 1/2 Dearfield Dr
Suite 101
Greenwich, CT 06831-5335
Phone (203) 861-9586

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
I20170313001505 NY Practitioner - Obstetrics/Gynecology 7618110495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054416CTMDObstetrics & Gynecology Physician
69687GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Dec 27, 2016 Accepting new patients
Sun River Health Inc Current Accepting new patients
South Shore University Hospital Past Accepting new patients
Women'S Community Care, PC Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

1200 Brown St
Peekskill, NY 10566
Phone (845) 838-7020

Networks

  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: patricia.palos@hrh.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1083858682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 1/2 DEARFIELD DR",
            "address_2": "SUITE 101",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315335",
            "telephone_number": "203-861-9586",
            "fax_number": "203-861-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 1/2 DEARFIELD DR",
            "address_2": "SUITE 101",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315335",
            "telephone_number": "203-861-9586",
            "fax_number": "203-861-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOS",
        "first_name": "PATRICIA",
        "middle_name": "EILLEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "69687",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "054416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.