Individual provider Active NPI

Martha Cecilia Pelaez, RN

  • Registered Nurse
  • Ridgewood, NY
National Provider Identifier
1174038566
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
636670 Issued in NY
Practice address
6918 65TH St
Ridgewood, NY 11385-5275
Phone
(646) 938-6865
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 636670 NY Primary

Addresses

Primary practice location

6918 65TH St
Ridgewood, NY 11385-5275

Mailing address

6918 65TH St
Ridgewood, NY 11385-5275
Phone (646) 938-6865

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
636670NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1174038566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 65TH ST",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855275",
            "telephone_number": "646-938-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 65TH ST",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855275",
            "telephone_number": "646-938-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELAEZ",
        "first_name": "MARTHA",
        "middle_name": "CECILIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "636670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.