Active NPI
Peri Dana Degrazia, CNM, WHNP
- Women's Health Nurse Practitioner
- New York, NY
National Provider Identifier
1396941969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- F420853-1
- Practice address
- 103 5TH Ave
Third Floor
New York, NY 10003-1009 - Phone
- (212) 366-4765
- Fax
- (212) 229-1020
- NPI assigned
- Jun 21, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | F420853-1 | NY | Primary |
| Advanced Practice Midwife | 367A00000X | F001272-1 | NY |
Addresses
Primary practice location
103 5TH Ave
Third Floor
New York, NY 10003-1009
Mailing address
103 5TH Ave
Suite 3
New York, NY 10003-1009
Phone (212) 366-4765
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F001272-1 | Other | NY | CNM LICENSE NUMBER |
| 565709-1 | Other | NY | RN LICENSE NUMBER |
Other names 1
- Ms. Peri Dana Jacobson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F420853-1 | NY | MD | Women's Health Nurse Practitioner |
| F001272-1 | NY | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257724800000",
"number": "1396941969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 5TH AVE",
"address_2": "SUITE 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100031009",
"telephone_number": "212-366-4765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 5TH AVE",
"address_2": "THIRD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100031009",
"telephone_number": "212-366-4765",
"fax_number": "212-229-1020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRAZIA",
"first_name": "PERI",
"middle_name": "DANA",
"name_prefix": "Ms.",
"credential": "CNM, WHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-21",
"last_updated": "2009-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "NY",
"license": "F420853-1",
"primary": true
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "F001272-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNM LICENSE NUMBER",
"identifier": "F001272-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE NUMBER",
"identifier": "565709-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PERI",
"last_name": "JACOBSON",
"middle_name": "DANA",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.