Individual provider Active NPI

Amy E Peardon, DO

  • Pediatrics Physician
  • Asbury Park, NJ
National Provider Identifier
1548223282
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MB07560400 Issued in NJ
Practice address
516 Bangs Ave
Asbury Park, NJ 07712-6902
Phone
(732) 774-0262
Fax
(732) 775-8963
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MB07560400 NJ Primary

Addresses

Primary practice location

516 Bangs Ave
Asbury Park, NJ 07712-6902

Mailing address

516 Bangs Ave
Asbury Park, NJ 07712-6902
Phone (732) 774-0262

Other identifiers 1

IdentifierTypeStateIssuer
0093360MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070508000000 NJ Practitioner - Pediatric Medicine 6204932221 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB07560400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Pediatrics CurrentSince Jan 1, 2015 Accepting new patients
Autism Testing Specialists LLC Pediatrics Current Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

516 Bangs Ave
Asbury Park, NJ 07712
Phone (732) 774-0262

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • Direct secure messaging: amy.peardon@direct.hackensackmeridian.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1548223282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 BANGS AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077126902",
            "telephone_number": "732-774-0262",
            "fax_number": "732-775-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 BANGS AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077126902",
            "telephone_number": "732-774-0262",
            "fax_number": "732-775-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARDON",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB07560400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093360",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asbury Park, NJ

Sources for this page

Verify at the official NPI Registry.