Active NPI
Kelvin Peralta, O.D
- Optometrist
- Bronx, NY
National Provider Identifier
1376097477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV008422
- Practice address
- 2742A E Tremont Ave
Bronx, NY 10461-2808 - Phone
- (347) 422-7380
- Fax
- (347) 772-3032
- NPI assigned
- Aug 8, 2016
- Last updated
- Aug 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV008422 | NY | Primary |
Addresses
Primary practice location
2742A E Tremont Ave
Bronx, NY 10461-2808
Mailing address
2742A E Tremont Ave
Bronx, NY 10461-2808
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
839 E 149TH St
Bronx, NY 10455-4662
Phone (718) 576-1993
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV008422 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tristate Optometry PLLC | Optometrist | Current | Accepting new patients |
| Jamaica Eye Care Center LLC | Optometrist | Current | Accepting new patients |
Locations
839 E 149th St
Bronx, NY 10455
Phone (678) 557-5380
16820 Jamaica Ave
Jamaica, NY 11432
Phone (718) 523-0060
Organizations & group practices 2
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.
-
- Optometrist
- Jamaica, NY
- NPI 1912466707
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470614400000",
"number": "1376097477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2742A E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104612808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2742A E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104612808",
"telephone_number": "347-422-7380",
"fax_number": "347-772-3032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERALTA",
"first_name": "KELVIN",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-08",
"last_updated": "2016-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV008422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.