Eric John Peltz

Primary specialty

Adult CompanionTaxonomy code 372600000X

License

1103722 Issued in MN

Practice address

898 322ND Ave NE
Cambridge, MN 55008-5810

Phone

(763) 234-3308

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1245855816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 322ND AVE NE",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550085810",
            "telephone_number": "763-234-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "898 322ND AVE NE",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550085810",
            "telephone_number": "763-234-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTZ",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Adult Companion",
            "state": "MN",
            "license": "1103722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN ADULT FOSTER CARE LICENSE",
            "identifier": "1103722",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DHS 245D LICENSE - ADULT FOSTER CARE LICENSE",
            "identifier": "1104550",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Marie Paul, BS, MA
• Angela Jean Pearson
• David J Pearson, MD
• Raena Elizabeth Pelkey
• Andrew D Peltier, MD
• Kristin Peltz
• Stuart R Pemberton, MD
• Abbe Jennifer Penziner-Bokde, MD
• McKenzie Lynn Perkins
• Margaret Mary Peterson

• Adult Companion in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Adult Companion in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.