Individual provider Active NPI

Eduardo M Perelstein, MD

  • Pediatric Nephrology Physician
  • New York, NY
National Provider Identifier
1437246501
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
189185 Issued in NY
Practice address
428 E 72ND St Ofc 100
New York, NY 10021-4635
Phone
(212) 746-3260
Fax
(212) 746-8861
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 189185 NY
Pediatric Nephrology Physician 2080P0210X 189185 NY Primary

Addresses

Primary practice location

428 E 72ND St Ofc 100
New York, NY 10021-4635

Mailing address

428 E 72ND St Ofc 100
New York, NY 10021-4635
Phone (212) 746-0373

Other identifiers 1

IdentifierTypeStateIssuer
0150050MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20060118000867 NY Practitioner - Pediatric MedicinePractitioner - NeurologyPractitioner - Nephrology 4183648090 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
189185NYMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Pediatrics CurrentSince Jul 1, 2008 Accepting new patients
Kings Physician Services, PC CurrentSince Aug 1, 2020 Accepting new patients
Kings Physician Services, PC CurrentSince Aug 1, 2020 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 5, 2017 Accepting new patients
Memorial Pediatric Group Pediatrics CurrentSince Feb 5, 2015 Accepting new patients
New York Queens Medicine and Surgery, P.C. Pediatrics CurrentSince Nov 5, 2017 Accepting new patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2008 Accepting new patients

Locations

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

428 E 72nd St
Ofc 100
New York, NY 10021
Phone (212) 746-3576

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Interoperability endpoints

  • Direct secure messaging: emperels@direct.nyp.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1437246501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 E 72ND ST OFC 100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214635",
            "telephone_number": "212-746-0373",
            "fax_number": "212-746-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 E 72ND ST OFC 100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214635",
            "telephone_number": "212-746-3260",
            "fax_number": "212-746-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERELSTEIN",
        "first_name": "EDUARDO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "189185",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NY",
            "license": "189185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150050",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.