Active NPI
Lucille Perrotta, MD
- Pediatrics Physician
- New York, NY
National Provider Identifier
1528049848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 107428
- Practice address
- 1St Avenue at 16TH St
New York, NY 10003 - Phone
- (212) 420-4637
- NPI assigned
- Nov 14, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 107428 | NY | Primary |
Addresses
Primary practice location
1St Avenue at 16TH St
New York, NY 10003
Mailing address
PO Box 32889
Hartford, CT 06150-2889
Phone (212) 256-3539
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00547957 | Medicaid | NY |
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 |
|---|---|---|---|
| 107428 | NY | MD | Specialist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416268800000",
"number": "1528049848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 32889",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061502889",
"telephone_number": "212-256-3539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1ST AVENUE AT 16TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10003",
"telephone_number": "212-420-4637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERROTTA",
"first_name": "LUCILLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-14",
"last_updated": "2014-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "107428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00547957",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.