Individual provider Active NPI

Marcia Pehr, DO

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1265655575
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
136405 Issued in NY
Practice address
1262 Boston Rd
Suite 2
Bronx, NY 10456-3602
Phone
(718) 569-7929
Fax
(347) 590-5482
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 136405 NY Primary

Addresses

Primary practice location

1262 Boston Rd
Suite 2
Bronx, NY 10456-3602

Mailing address

1262 Boston Rd
Suite 2
Bronx, NY 10456-3602
Phone (718) 569-7929

Other identifiers 1

IdentifierTypeStateIssuer
01235336MedicaidNY

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
I20040312000198 NY Practitioner - Emergency Medicine 4385533918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
181St Street Medical PCGroup PAC ID 8022242130, 8 clinicians

Practice addresses (Care Compare)

521 W 181St St
New York, NY 10033-5102
Phone 7328735133425

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136405NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Audubon Primary Care Medicine PLLC CurrentSince Mar 1, 2014 Accepting new patients
181St Street Medical P.C. CurrentSince Mar 1, 2014 Accepting new patients
The Blue Hill Memorial Hospital Past Accepting new patients

Locations

521 W 181st St
New York, NY 10033
Phone (347) 756-6000

325 Audubon Ave
New York, NY 10033
Phone (718) 664-7679

Networks

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

Interoperability endpoints

  • Direct secure messaging: marcia.pehr@cgm.eclinicaldirectplus.com

Organizations & group practices 4

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1265655575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 BOSTON RD",
            "address_2": "SUITE 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563602",
            "telephone_number": "718-569-7929",
            "fax_number": "347-590-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1262 BOSTON RD",
            "address_2": "SUITE 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563602",
            "telephone_number": "718-569-7929",
            "fax_number": "347-590-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEHR",
        "first_name": "MARCIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "136405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01235336",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.