Active NPI
Ruthann Perillo, MD
- Internal Medicine Physician
- Huntington Station, NY
National Provider Identifier
1528065562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 207519-1
- Practice address
- 180 E Pulaski Rd
Huntington Station, NY 11746-1915 - Phone
- (631) 425-2121
- Fax
- (631) 425-2193
- NPI assigned
- Jul 6, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 207519-1 | NY | Primary |
Addresses
Primary practice location
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Mailing address
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (631) 425-2121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01944696 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rperillo104987@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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207519-1 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Internal Medicine | Current | Accepting new patients |
| New York University | Internal Medicine | Current | Accepting new patients |
Locations
180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
Internal Medicine, NY
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1528065562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 E PULASKI RD",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117461915",
"telephone_number": "631-425-2121",
"fax_number": "631-425-2193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 E PULASKI RD",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117461915",
"telephone_number": "631-425-2121",
"fax_number": "631-425-2193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERILLO",
"first_name": "RUTHANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "207519-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01944696",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rperillo104987@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "180 E Pulaski Rd",
"city": "Huntington Station",
"state": "NY",
"country_code": "US",
"postal_code": "117461915",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Huntington Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.