Individual provider Active NPI

Gerard Pellegrini, D.O.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1336707892
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
319163-01 Issued in NY
Practice address
160 E Erie Ave
Philadelphia, PA 19134-1011
Phone
(215) 427-4067
NPI assigned
May 30, 2019
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 319163-01 NY Primary
Pediatrics Physician 208000000X 25MB13047000 NJ
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X OS025130 PA

Addresses

Primary practice location

160 E Erie Ave
Philadelphia, PA 19134-1011

Mailing address

990 Corporate Dr Apt 514
Westbury, NY 11590-6721

Other practice location 1

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4010

Other practice location 2

506 6th St
Brooklyn, NY 11215-3609
Phone (718) 780-5040

Other practice location 3

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230320001246 NY Practitioner - Pediatric Medicine 2062886724 Reassigns benefits to 1 organization
I20250715000178 PA Practitioner - Pediatric Medicine 2062886724 Reassigns benefits to 1 organization
I20260509000258 NJ Practitioner - Pediatric Medicine 2062886724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
STC Pediatrics LLCGroup PAC ID 7315372323, 73 clinicians

Practice addresses (Care Compare)

160 E Erie Ave
Philadelphia, PA 19134-1011
Phone (215) 427-6778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB13047000NJMDPediatrics Physician
319163-01NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 24, 2023 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Jul 11, 2025 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Jul 11, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 24, 2023 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Interoperability endpoints

  • Direct secure messaging: gep7007@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1336707892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 CORPORATE DR APT 514",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-4067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Capital Way",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "085342520",
            "country_code": "US",
            "telephone_number": "609-303-4010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-5040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "NJ",
            "postal_code": "086384143",
            "country_code": "US",
            "telephone_number": "609-394-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "GERARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "319163-01",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB13047000",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "PA",
            "license": "OS025130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.