Organization Active NPI

Perry Medical Group of Florida PA

  • General Practice Physician
  • New York, NY
National Provider Identifier
1194394833
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PERRY MEDICAL GROUP OF FLORIDA PA
Practice address
169 Madison Ave Ste 90030
New York, NY 10016-5101
Phone
(978) 850-3914
Fax
(646) 365-0517
NPI assigned
Jun 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Jennifer Harless
Title
Director, RCM
Phone
(508) 494-8275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

169 Madison Ave Ste 90030
New York, NY 10016-5101

Mailing address

169 Madison Ave Ste 90030
New York, NY 10016-5101
Phone (978) 850-3914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, GA, TX, NJ, WY, MS, NC, AR, CA, CO, IL, PA, IN, HI, MA16 enrollments

Enrollment records 16

Enrollment IDStateProvider typePAC IDDetails
O20210804003321 NY Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY; Tuxedo Park, NY
O20230426000128 FL Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 3 practitioners
Practice locations: Beverly Hills, FL; Miami, FL; Tampa, FL
O20230517001000 GA Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 3 practitioners
Practice locations: Dacula, GA; Decatur, GA; Kathleen, GA; Marietta, GA; McDonough, GA; Stone MTN, GA
O20230519001241 TX Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 5 practitioners
Practice locations: Dallas, TX; Fort Worth, TX; Katy, TX; Rowlett, TX
O20230522002043 NJ Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 2 practitioners
Practice locations: Manalapan, NJ; Medford, NJ
O20230522002786 WY Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Green River, WY
O20230728001850 MS Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Hernando, MS
O20230809002195 NC Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 2 practitioners
Practice locations: Franklin, NC; Harrisburg, NC; Tryon, NC
O20231003000213 AR Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Monticello, AR
O20231110001938 CA Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA; Irvine, CA; Petaluma, CA
O20240206001686 CO Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Bellvue, CO; Silverthorne, CO
O20240207002807 IL Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL; Geneva, IL
O20240208003912 PA Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 2 practitioners
Practice locations: Schwenksville, PA; Tobyhanna, PA
O20240927000681 IN Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 2 practitioners
Practice locations: Terre Haute, IN; Valparaiso, IN
O20241024002934 HI Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI
O20250226000604 MA Part B Supplier - Clinic/Group Practice 8729481197 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly, MA; Danvers, MA

National Provider Directory

National Provider Directory

Locations

1 Sansome St
Fl 12
San Francisco, CA 94104

2853 Candler Rd
Decatur, GA 30034

99 Conifer Hill Dr
Ste 300
Danvers, MA 01923

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1194394833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 90030",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "978-850-3914",
            "fax_number": "646-365-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 90030",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "978-850-3914",
            "fax_number": "646-365-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY MEDICAL GROUP OF FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "HARLESS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR, RCM",
        "authorized_official_telephone_number": "508-494-8275"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.