Individual provider Active NPI

Betty Ann Perine, RN CNM NP

  • Advanced Practice Midwife
  • New York, NY
National Provider Identifier
1295887123
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F0004851 Issued in NY
Practice address
1111 Amsterdam Avenue
St Lukes Roosevelt Hospital Clark 2 OB GYN
New York, NY 10025
Phone
(212) 523-3720
Fax
(212) 523-1723
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3457381 NY
Women's Health Nurse Practitioner 363LW0102X F4204821 NY
Advanced Practice Midwife 367A00000X F0004851 NY Primary

Addresses

Primary practice location

1111 Amsterdam Avenue
St Lukes Roosevelt Hospital Clark 2 OB GYN
New York, NY 10025

Mailing address

5445 Fieldston Road
Bronx, NY 10471
Phone (347) 427-1036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
3457381NYMDRegistered Nurse
F4204821NYMDWomen's Health Nurse Practitioner
F0004851NYMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1295887123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 FIELDSTON ROAD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10471",
            "telephone_number": "347-427-1036",
            "fax_number": "347-427-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVENUE",
            "address_2": "ST LUKES ROOSEVELT HOSPITAL CLARK 2 OB GYN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-523-3720",
            "fax_number": "212-523-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERINE",
        "first_name": "BETTY",
        "middle_name": "ANN",
        "credential": "RN CNM NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "3457381",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F4204821",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F0004851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.