Michael John Peck II

Primary specialty

Orthotic FitterTaxonomy code 225000000X

Practice address

669 Boston Post Rd
Guilford, CT 06437-2739

Phone

(617) 515-3970

NPI assigned

Aug 31, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Innova Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Guilford, CT
  • NPI 1659073120
  NPD Authorized official
• Northeast Medical Products, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Old Saybrook, CT
  • NPI 1770687485
  NPD Authorized official

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1386364206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 BOSTON POST RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372739",
            "telephone_number": "617-515-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 BOSTON POST RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372739",
            "telephone_number": "617-515-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arpita S Patel, D.D.S.
• Komal Dilipkumar Patel, FNP-C
• Prerana Purohit Patel, LPC
• Vipul Patel, RPH
• Pathways to the Heart: Sexuality, Intimacy, & Relational Therapy LLC
• Pediatric Eye Care LLC
• Pediatric Hematology-Oncology Associates, PC
• Emma Pellegrino, PA-C
• Shadaneysa Pelzer
• Cristina P Pereira

• Orthotic Fitter in Guilford, CT
• Providers in Guilford, CT by specialty
• Orthotic Fitter in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.