Arlene Pericak, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F330373-1 Issued in NY

Practice address

942A Route 146
Clifton Park, NY 12065-3614

Phone

(518) 371-8000

Fax

(518) 371-5338

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1225055890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942A ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653614",
            "telephone_number": "518-371-8000",
            "fax_number": "518-371-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942A ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653614",
            "telephone_number": "518-371-8000",
            "fax_number": "518-371-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERICAK",
        "first_name": "ARLENE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330373-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-HMO",
            "identifier": "671204",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "120118000008",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02408120",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen M Patterson, FNP-BC
• Holly Denise Payne, M.D.
• Peace Mental Health Counseling PLLC
• Anita Peetush Astley, M.ED
• Ryan Joseph Pelton
• Danielle Perretta
• Danielle Petrone, PT
• Amy C Pfaffenbach, D.D.S.
• Geraldine G C Pfeiffer, PT
• Karen Phillips, MSPT

• Family Nurse Practitioner in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.