Individual provider Active NPI

Bradford Benton Perry, M.D.

  • Psychiatry Physician
  • Scarsdale, NY
National Provider Identifier
1205940210
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
162803 Issued in NY
Practice address
455 Central Avenue
Suite 214
Scarsdale, NY 10583-1102
Phone
(914) 472-2167
Fax
(914) 472-2097
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 162803 NY Primary

Addresses

Primary practice location

455 Central Avenue
Suite 214
Scarsdale, NY 10583-1102

Mailing address

455 Central Avenue
Suite 214
Scarsdale, NY 10583-1102
Phone (914) 472-2167

Other identifiers 4

IdentifierTypeStateIssuer
01064020MedicaidNY
P558687OtherNYOXFORD
109817OtherNYMHN
147571OtherNYVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000001 NY Practitioner - Psychiatry 1759553605 Practice locations: Scarsdale, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

455 Central Park Ave
Scarsdale, NY 10583-1034
Phone (914) 472-2167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205940210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CENTRAL AVENUE",
            "address_2": "SUITE 214",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831102",
            "telephone_number": "914-472-2167",
            "fax_number": "914-472-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 CENTRAL AVENUE",
            "address_2": "SUITE 214",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831102",
            "telephone_number": "914-472-2167",
            "fax_number": "914-472-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "BRADFORD",
        "middle_name": "BENTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "162803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01064020",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P558687",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "109817",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "147571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.