Peter Perera, D.M.D., PA.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18338 Issued in NJ

Practice address

33 Sicomac Road
Suite 202
North Haledon, NJ 07508-2971

Phone

(973) 427-0300

Fax

(973) 427-7745

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1417049255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SICOMAC ROAD",
            "address_2": "SUITE 202",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082971",
            "telephone_number": "973-427-0300",
            "fax_number": "973-427-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SICOMAC ROAD",
            "address_2": "SUITE 202",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082971",
            "telephone_number": "973-427-0300",
            "fax_number": "973-427-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERERA",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.M.D., PA.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "18338",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI018338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Haledon Medical
• Carmen John Occhiuzzi, D.C.
• Optimum Vitality
• Chelsea Otte, LAT, ATC
• Evelyn Paz
• Barbara A. Porcelli, LCSW
• Jennifer Puskas, LCSW
• R & a Staffing LLC
• Brian D Raineri, PHARMD
• David L. Rajkowski, O.D.

• General Practice Dentistry in North Haledon, NJ
• Providers in North Haledon, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.