Active NPI
Peter R. Breggin, MD
- Psychiatry Physician
- Ithaca, NY
National Provider Identifier
1457542862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 093436-1
- Practice address
- 313 N Tioga St
First Floor
Ithaca, NY 14850-4205 - Phone
- (607) 272-5328
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 093436-1 | NY | Primary |
Addresses
Primary practice location
313 N Tioga St
First Floor
Ithaca, NY 14850-4205
Mailing address
101 E State St
No. 112
Ithaca, NY 14850-5543
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 093436-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1457542862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E STATE ST",
"address_2": "NO. 112",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 N TIOGA ST",
"address_2": "FIRST FLOOR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148504205",
"telephone_number": "607-272-5328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREGGIN",
"first_name": "PETER",
"middle_name": "R.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "093436-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.