Active NPI
Alise Peckjian, MD
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1215558499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD481018
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (215) 590-7131
- NPI assigned
- Apr 29, 2020
- Last updated
- Aug 31, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD481018 | PA | Primary |
| Psychiatry Physician | 2084P0800X | MT220666 | PA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA13267000 | NJ |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935
Other practice location 1
3 Cooper Plz Rm 307
Camden, NJ 08103-1438
Phone (856) 342-2328
Other practice location 2
3535 Market St Fl 2
Philadelphia, PA 19104-3317
Phone (866) 301-4724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD481018 | PA | MD | Pediatrics Physician |
| MT220666 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1215558499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FEDERAL ST STE 200",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031088",
"telephone_number": "848-288-6935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-7131"
}
],
"practiceLocations": [
{
"address_1": "3 Cooper Plz Rm 307",
"address_purpose": "LOCATION",
"city": "Camden",
"state": "NJ",
"postal_code": "081031438",
"country_code": "US",
"telephone_number": "856-342-2328",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3535 Market St Fl 2",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191043317",
"country_code": "US",
"telephone_number": "866-301-4724",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PECKJIAN",
"first_name": "ALISE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-29",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD481018",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MT220666",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MA13267000",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.