Individual provider Active NPI

Peter S Deluca, MD

  • Pulmonary Disease Physician
  • Huntington, NY
National Provider Identifier
1598832826
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
139292 Issued in NY
Practice address
120 New York Ave
Suite 6W
Huntington, NY 11743
Phone
(631) 351-1144
Fax
(631) 351-1143
NPI assigned
Nov 30, 2006
Last updated
Oct 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 139292 NY Primary

Addresses

Primary practice location

120 New York Ave
Suite 6W
Huntington, NY 11743

Mailing address

120 New York Ave
Suite 6W
Huntington, NY 11743
Phone (631) 351-1144

Other identifiers 1

IdentifierTypeStateIssuer
00764250MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040702001005 NY Practitioner - Pulmonary Disease 7719964139 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139292NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Current Accepting new patients
Huntington Pulmonary PC Pulmonary Disease Current Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Mar 22, 2011 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Mar 22, 2011 Accepting new patients

Locations

120 New York Ave
Huntington, NY 11743
Phone (631) 351-3766

120 New York Ave
Ste 6
Huntington, NY 11743
Phone (516) 351-1144

120 New York Ave
Ste 6W
Huntington, NY 11743
Phone (516) 578-6104

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1598832826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NEW YORK AVE",
            "address_2": "SUITE 6W",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-351-1144",
            "fax_number": "631-351-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NEW YORK AVE",
            "address_2": "SUITE 6W",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-351-1144",
            "fax_number": "631-351-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "PETER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "139292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00764250",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.