Individual provider Active NPI

Juan Peralta

  • Mental Health Counselor
  • Philadelphia, PA
National Provider Identifier
1184012288
Registry record updated Sep 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2120 E Sergeant St
Philadelphia, PA 19125-1729
Phone
(646) 327-2059
NPI assigned
Dec 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2120 E Sergeant St
Philadelphia, PA 19125-1729

Mailing address

2120 E Sergeant St
Philadelphia, PA 19125-1729
Phone (646) 327-2059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241023000179 PA Practitioner - Mental Health Counselor 5294268702 Reassigns benefits to 1 organization
I20250228000397 NY Practitioner - Mental Health Counselor 5294268702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Minds Mental Health Counseling Services PLLCGroup PAC ID 4385177898, 3 clinicians

Practice addresses (Care Compare)

Philadelphia, PA 19125
Phone (646) 327-2059

3060 Albany Cres
Apt 33
Bronx, NY 10463-5637
Phone (475) 882-6872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Minds Nyc PLLC Mental Health CurrentSince Dec 30, 2024 Accepting new patients

Organizations & group practices 2

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": "1419552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1184012288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 E SERGEANT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251729",
            "telephone_number": "646-327-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E SERGEANT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251729",
            "telephone_number": "646-327-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "JUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-26",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.