Individual provider Active NPI

Peter Kim Nelson, M.D.

  • Neuroradiology Physician
  • New York, NY
National Provider Identifier
1457317042
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
190775 Issued in NY
Practice address
560 1St Ave
New York, NY 10016-6402
Phone
(212) 263-6008
Fax
(212) 263-0405
NPI assigned
Apr 24, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 190775 NY Primary
Diagnostic Radiology Physician 2085R0202X 190775 NY

Addresses

Primary practice location

560 1St Ave
New York, NY 10016-6402

Mailing address

7211 Austin St
PMB#151
Forest Hills, NY 11375-5354

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pnelson9008@nyumc.direct-ci.com

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
I20050420001353 NY Practitioner - Diagnostic Radiology 5395783252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
FL 2
New York, NY 10006-1995
Phone (212) 263-9701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 21, 2012 Accepting new patients
New York University CurrentSince Aug 21, 2012 Accepting new patients
New York University Medical Center Faculty Practice Radiology Diagnostic Radiology Past Accepting new patients
Nyumc Radiology Associates Diagnostic Radiology Past Accepting new patients
Tibor Becske, MD, PLLC Neuroradiology PastSince Jun 1, 2004 Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

560 1st Ave
New York, NY 10016
Phone (212) 263-5362

560 1st Ave
#208
New York, NY 10016
Phone (212) 263-6008

560 1st Ave
Rm HE208
New York, NY 10016
Phone (212) 263-6008

660 1st Ave
New York, NY 10016
Phone (212) 263-0001

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

111 Broadway
Fl 2
Trinity, NY 10006
Phone (212) 263-9700

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: pnelson9008@nyumc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1457317042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 AUSTIN ST",
            "address_2": "PMB#151",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-6008",
            "fax_number": "212-263-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PETER",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "190775",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "190775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pnelson9008@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "560 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.