Individual provider Active NPI

Lisandra Peguero

  • Developmental Therapist
  • Dorchester, MA
National Provider Identifier
1598208118
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
69 Stanwood St Apt 1
Dorchester, MA 02121-2740
Phone
(617) 676-8001
NPI assigned
Nov 30, 2016
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X NU Primary

Addresses

Primary practice location

69 Stanwood St Apt 1
Dorchester, MA 02121-2740

Mailing address

69 Stanwood St Apt 1
Dorchester, MA 02121-2740

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

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1598208118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 STANWOOD ST APT 1",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021212740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 STANWOOD ST APT 1",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021212740",
            "telephone_number": "617-676-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUERO",
        "first_name": "LISANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.