Peachtree Podiatry,PLLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

65-006692 Issued in NY

Legal business name

PEACHTREE PODIATRY,PLLC

Practice address

45 S Grove St Apt 1
East Aurora, NY 14052-2365

Phone

(716) 970-4598

Fax

(716) 970-4588

NPI assigned

Jul 29, 2015

Last updated

Jul 29, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andrea Luisa Peach, DPMNPI 1083875256

Title

Owner

Phone

(716) 970-4598

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea Luisa Peach, DPM

  • Podiatrist
  • Chicago, IL
  • NPI 1083875256

  NY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1508241852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S GROVE ST APT 1",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522365",
            "telephone_number": "716-970-4598",
            "fax_number": "716-970-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S GROVE ST APT 1",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522365",
            "telephone_number": "716-970-4598",
            "fax_number": "716-970-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PODIATRY,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "PEACH",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LUISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-970-4598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "65-006692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Mary Odachowski, P.T.
• Kip Alan Palmateer, A.T.,C
• Leslie Pasco
• Puja Patel
• Brynn Elizabeth Patterson, P.T.
• Nancy E Pearce, PTA
• Stephen K Pearl, M.D.
• Amy Perry, LCSW
• Deborah Petronio, D.D.S.
• James Joseph Petti, PHARM. D.

• Primary Podiatric Medicine Podiatrist in East Aurora, NY
• Providers in East Aurora, NY by specialty
• Primary Podiatric Medicine Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.