Active NPI
Peter Paul Percuoco, DC., DACNB
- Neurology Chiropractor
- Hudson, MA
National Provider Identifier
1164564902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- 1497
- Practice address
- 17 Main St
Hudson, MA 01749-2108 - Phone
- (978) 568-8077
- Fax
- (978) 562-3349
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 1497 | MA | Primary |
| Neurology Chiropractor | 111NN0400X | 001597 | CT |
Addresses
Primary practice location
17 Main St
Hudson, MA 01749-2108
Mailing address
17 Main St
P.O. Box 181
Hudson, MA 01749-2108
Phone (978) 568-8077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y36030 | Other | MA | BLUE CROSS BLUE SHIELD MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001597 | CT | MD | Optician |
| 1497 | MA | MD | Electroneurodiagnostic Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301875200000",
"number": "1164564902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MAIN ST",
"address_2": "P.O. BOX 181",
"city": "HUDSON",
"state": "MA",
"postal_code": "017492108",
"telephone_number": "978-568-8077",
"fax_number": "978-562-3349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 MAIN ST",
"city": "HUDSON",
"state": "MA",
"postal_code": "017492108",
"telephone_number": "978-568-8077",
"fax_number": "978-562-3349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERCUOCO",
"first_name": "PETER",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DC., DACNB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2011-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "MA",
"license": "1497",
"primary": true
},
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "CT",
"license": "001597",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MA",
"identifier": "Y36030",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hudson, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.