Peter Ercolino, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Practice address

1655 Wake Drive
Ste 101
Wake Forest, NC 27587

Phone

(919) 556-4779

Fax

(919) 556-5277

NPI assigned

Jun 30, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peterercolino@wfpapllc.allscriptsdirect.net

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.

• Wake Forest Pediatric Associates, PLLC

  • Pediatrics Physician
  • Wake Forest, NC
  • NPI 1790782126

  NC, Pediatrics

  Medicare reassignment NPD
• Wake Forest Pediatric Associates, PLLC

  • Pediatrics Physician
  • Knightdale, NC
  • NPI 1790973469

  Pediatrics

  NPD

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386641850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 BELSPRING LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125229",
            "telephone_number": "919-782-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 WAKE DRIVE",
            "address_2": "STE 101",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-556-4779",
            "fax_number": "919-556-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERCOLINO",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126J5",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enriched Psychotherapeutic Services PLLC
• Envision Solutions Therapy
• Epiphany Pelvic Health Physical Therapy LLC
• Epistell Transport LLC
• Ronald Alan Epner, M.D.
• Michelle Marie Erickson, M.A., CRC
• Heidi Louise Trollman Erwin, RD, LDN
• Luma Essaid, MD
• Essential Touch, Inc
• Naromie Estael

• Pediatrics Physician in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.