Edward Peguero, ORTHOTIST

Primary specialty

OrthotistTaxonomy code 222Z00000X

Practice address

8211 37TH Avenue Suite LL19
Jackson Heights, NY 11372

Phone

(718) 255-1986

Fax

(718) 255-1989

NPI assigned

Apr 4, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1588953293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20911 41ST AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611926",
            "telephone_number": "551-580-2711",
            "fax_number": "718-225-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 37TH AVENUE SUITE LL19",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-255-1986",
            "fax_number": "718-255-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUERO",
        "first_name": "EDWARD",
        "credential": "ORTHOTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthotist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Orthotist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.