Individual provider Active NPI

Guy J Pean, MD

  • Addiction Medicine (Family Medicine) Physician
  • New York, NY
National Provider Identifier
1255442513
Registry record updated Aug 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
201871 Issued in NY
Practice address
177 E 122ND St
New York, NY 10035-2906
Phone
(212) 360-7116
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 201871 NY Primary

Addresses

Primary practice location

177 E 122ND St
New York, NY 10035-2906

Mailing address

721 E 48TH St
Brooklyn, NY 11203-5801
Phone (718) 451-1128

Other identifiers 1

IdentifierTypeStateIssuer
01701431MedicaidNY

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
I20070630000060 NY Practitioner - Addiction MedicinePractitioner - General PracticePractitioner - Family Practice 6204935356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Family Practice, General Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palladia IncGroup PAC ID 9032651914, 5 clinicians

Practice addresses (Care Compare)

177 E 122ND St
FL 2
New York, NY 10035-2906
Phone (212) 360-7116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201871NYMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Create, Inc. CurrentSince Jan 27, 2015 Accepting new patients
Sus Mental Health Programs, Inc. CurrentSince Aug 3, 2024 Accepting new patients
Palladia Inc CurrentSince Aug 3, 2024 Accepting new patients
Bronx Addiction Services Integrated Concepts System Inc PastSince Jan 20, 2009 Accepting new patients
Genesis Detox of Brooklyn, LLC Past Accepting new patients
Camelot of Staten Island, Inc. Past Accepting new patients

Locations

760 E 160th St
Bronx, NY 10456
Phone (347) 503-5527

1125 Fulton St
Ste 2
Brooklyn, NY 11238
Phone (347) 226-9025

177 E 122nd St
New York, NY 10035
Phone (212) 360-7116

463 Fashion Ave
Fl 17
New York, NY 10018
Phone 64656558165816

177 E 122nd St
Fl 2
New York, NY 10035
Phone (212) 360-7116

73 Lenox Ave
New York, NY 10026
Phone (212) 663-1596

73 Malcolm X Blvd
New York, NY 10026
Phone (212) 663-1596

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788048000000",
    "number": "1255442513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 E 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035801",
            "telephone_number": "718-451-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 E 122ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352906",
            "telephone_number": "212-360-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAN",
        "first_name": "GUY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "201871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01701431",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.