Individual provider Active NPI

Alexandra Peck

  • Family Nurse Practitioner
  • Southampton, NY
National Provider Identifier
1306501994
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
348706 Issued in NY
Practice address
2 Montauk Hwy
Southampton, NY 11968-4199
Phone
(646) 962-9920
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 348706 NY Primary

Addresses

Primary practice location

2 Montauk Hwy
Southampton, NY 11968-4199

Mailing address

92 Evergreen Ave
East Moriches, NY 11940-1538
Phone (631) 603-2956

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address alr9135@direct.nyp.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230207000270 NY Practitioner - Nurse Practitioner 8628440344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York Downstate Medical Center, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

2315 Broadway
New York, NY 10024-4332
Phone (646) 962-7300

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
348706NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Oct 7, 2022 Accepting new patients
Weill Medical College of Cornell CurrentSince Oct 7, 2022 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Cornell University Medical College Past Accepting new patients
Weill Cornell University Medical College Past Accepting new patients

Locations

12 W 72nd St
New York, NY 10023
Phone (212) 746-7800

575 Lexington Ave
Rm 540
New York, NY 10022
Phone (646) 962-2543

425 E 61st St
Fl 12
New York, NY 10065
Phone (646) 962-2399

40 Worth St
Rm 402
New York, NY 10013
Phone (646) 962-3400

215 E 85th St
New York, NY 10028
Phone (646) 962-7300

2315 Broadway
New York, NY 10024
Phone (212) 746-3278

2315 Broadway
Fl 3
New York, NY 10024
Phone (646) 962-2842

428 E 72nd St
Ofc 300
New York, NY 10021
Phone (212) 746-2083

2 Montauk Hwy
Southampton, NY 11968
Phone (646) 962-4676

Interoperability endpoints

  • Direct secure messaging: alr9135@direct.nyp.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1306501994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 EVERGREEN AVE",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401538",
            "telephone_number": "631-603-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MONTAUK HWY",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684199",
            "telephone_number": "646-962-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "348706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2 Montauk Hwy",
            "city": "Southampton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "119684199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2 Montauk Hwy",
            "city": "Southampton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "119684199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alr9135@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "2 Montauk Hwy",
            "city": "Southampton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "119684199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.