NPIMap

Organization Active NPI

Peninsula Plastic Surgery P.C.

  • Plastic Surgery Physician
  • Salisbury, MD
National Provider Identifier
1598710485
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PENINSULA PLASTIC SURGERY P.C.
Practice address
314 W Carroll St
Suite 1
Salisbury, MD 21801-5305
Phone
(410) 546-0464
Fax
(410) 546-8529
NPI assigned
May 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Vincent J Perrotta, M.D.NPI 1720033541
Title
President
Phone
(410) 546-0464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD Primary

Addresses

Primary practice location

314 W Carroll St
Suite 1
Salisbury, MD 21801-5305

Mailing address

314 W Carroll St
Suite 1
Salisbury, MD 21801-5305
Phone (410) 546-0464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702001135 MD Part B Supplier - Clinic/Group Practice 2769469097 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Berlin, MD; Salisbury, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

30265 Commerce Dr
Unit 208
Millsboro, DE 19966
Phone (302) 663-0119

124 N Main St
Ste D
Berlin, MD 21811
Phone (410) 546-0464

314 W Carroll St
Ste 1
Salisbury, MD 21801
Phone (410) 546-0464

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598710485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W CARROLL ST",
            "address_2": "SUITE 1",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015305",
            "telephone_number": "410-546-0464",
            "fax_number": "410-546-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W CARROLL ST",
            "address_2": "SUITE 1",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015305",
            "telephone_number": "410-546-0464",
            "fax_number": "410-546-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PLASTIC SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PERROTTA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-546-0464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.