Active NPI
Josiah Petersen, M.D.
- Pediatrics Physician
- Oceanside, NY
National Provider Identifier
1376938902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 294319
- Practice address
- 1 Healthy Way
Oceanside, NY 11572-1551 - Phone
- (516) 632-3000
- NPI assigned
- Mar 31, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ML 60561474 | WA | |
| Pediatrics Physician | 208000000X | 294319 | NY | Primary |
Addresses
Primary practice location
1 Healthy Way
Oceanside, NY 11572-1551
Mailing address
1 Healthy Way
Oceanside, NY 11572-1551
Other practice location 1
4800 Sand Point Way NE
Oc.7.830
Seattle, WA 98105-3901
Phone (206) 987-2525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ML 60561474 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Nassau Communities Hospital | Current | Accepting new patients |
Locations
1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581
Interoperability endpoints
- josiahpetersen@snch.allscriptsdirect.net
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Oceanside, NY
- NPI 1922079094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552953600000",
"number": "1376938902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HEALTHY WAY",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115721551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HEALTHY WAY",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115721551",
"telephone_number": "516-632-3000"
}
],
"practiceLocations": [
{
"address_1": "4800 Sand Point Way NE",
"address_2": "OC.7.830",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981053901",
"country_code": "US",
"telephone_number": "206-987-2525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSEN",
"first_name": "JOSIAH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-31",
"last_updated": "2019-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "ML 60561474",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "294319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oceanside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.