NPIMap

Organization Active NPI

Philip a Penepent Jr.

  • Internal Medicine Physician
  • Bowmansville, NY
National Provider Identifier
1255526570
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PHILIP A PENEPENT JR.
Practice address
5196 Genesee St
Bowmansville, NY 14026-1038
Phone
(716) 681-1895
Fax
(716) 681-5439
NPI assigned
Sep 10, 2007
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Dr. Philip A Penepent Jr., M.D.
Title
Sole Proprietor
Phone
(716) 681-1895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

5196 Genesee St
Bowmansville, NY 14026-1038

Mailing address

5196 Genesee St
Bowmansville, NY 14026-1038
Phone (716) 681-1895

Other identifiers 1

IdentifierTypeStateIssuer
00751193MedicaidNY

National Provider Directory

National Provider Directory

Locations

5196 Genesee St
Bowmansville, NY 14026
Phone (716) 206-0005

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1255526570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5196 GENESEE ST",
            "city": "BOWMANSVILLE",
            "state": "NY",
            "postal_code": "140261038",
            "telephone_number": "716-681-1895",
            "fax_number": "716-681-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5196 GENESEE ST",
            "city": "BOWMANSVILLE",
            "state": "NY",
            "postal_code": "140261038",
            "telephone_number": "716-681-1895",
            "fax_number": "716-681-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A PENEPENT JR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "PENEPENT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "716-681-1895",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00751193",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowmansville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.