Active NPI
Perry Medical Group of Florida PA
- General Practice Physician
- New York, NY
National Provider Identifier
1194394833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 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, MA
Enrollment records 16
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
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.