Active NPI
Patricia Eillen Palos
- Obstetrics & Gynecology Physician
- Greenwich, CT
National Provider Identifier
1083858682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 054416
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054416 | CT | MD | Obstetrics & Gynecology Physician |
| 69687 | GA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun River Health Inc. | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Amenia, NY
- NPI 1568526838
-
- Federally Qualified Health Center (FQHC)
- Peekskill, NY
- NPI 1619969458
-
- General Acute Care Hospital
- Bay Shore, NY
- NPI 1457369381
-
- Gynecology Physician
- Fayetteville, GA
- NPI 1417167446
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.