Matthew Peltz

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL05901200 Issued in NJ

Practice address

714 Bergen Ave
Jersey City, NJ 07306-4802

Phone

(201) 682-2450

Fax

(201) 451-8300

NPI assigned

Apr 5, 2016

Last updated

Apr 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1174986251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064802",
            "telephone_number": "201-682-2450",
            "fax_number": "201-451-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064802",
            "telephone_number": "201-682-2450",
            "fax_number": "201-451-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTZ",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05901200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria S Pedoeem, D.D.S.
• Marquise Peel, ATC
• Pei Lin, MD
• Alicia Pelingon
• Ralph Pellecchia, M.D.
• Carissa Pelzel, FNP
• Krishna C Pendem
• Kelly Anne Pender, LMT
• Jordan Delynn Pendleton
• Pennreach

• Social Worker in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.

Verify at the official NPI Registry.