NPIMap

Individual provider Active NPI

Peter Douglas Angevine, M.D.

  • Neurological Surgery Physician
  • New York, NY
National Provider Identifier
1255384236
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
214404 Issued in NY
Practice address
710 W 168TH St
Room 510
New York, NY 10032-3726
Phone
(212) 305-1550
Fax
(212) 342-6850
NPI assigned
May 18, 2006
Last updated
Jan 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 214404 NY Primary

Addresses

Primary practice location

710 W 168TH St
Room 510
New York, NY 10032-3726

Mailing address

710 W 168TH St
Room 510
New York, NY 10032-3726
Phone (212) 305-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060522000062 NY Practitioner - Neurosurgery 1355313651 Reassigns benefits to 2 organizations
I20190509000773 NJ Practitioner - Neurosurgery 1355313651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Columbia University College of Physicians and Surgeons, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, shared by 10 NPIs, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion173
Laminectomy or laminotomy (partial removal of spine bones)80

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214404NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Doctors of New Jersey, P. C. CurrentSince Mar 16, 2019 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Mar 16, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 10, 2015 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 10, 2015 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

710 W 168th St
New York, NY 10032
Phone (212) 305-0217

710 W 168th St
#425
New York, NY 10032

710 W 168th St
Fl 5
New York, NY 10032
Phone (212) 305-1550

710 W 168th St
Rm 510
New York, NY 10032
Phone (212) 305-1550

710 W 168th St
Ste 425
New York, NY 10032
Phone (212) 305-1090

155 White Plains Rd
Tarrytown, NY 10591
Phone (914) 332-7571

1111 Westchester Ave
White Plains, NY 10604
Phone (212) 305-9137

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: angevin@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1255384236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "address_2": "ROOM 510",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-305-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "address_2": "ROOM 510",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-305-1550",
            "fax_number": "212-342-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGEVINE",
        "first_name": "PETER",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "214404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.