Individual provider Active NPI

Desmond Joesph Pegley, OTR/L

  • Occupational Therapist
  • Pearl River, NY
National Provider Identifier
1609067412
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013134-1 Issued in NY
Practice address
174 Forest Ave
Pearl River, NY 10965-1866
Phone
(914) 584-1011
NPI assigned
Aug 6, 2007
Last updated
Aug 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 013134-1 NY Primary

Addresses

Primary practice location

174 Forest Ave
Pearl River, NY 10965-1866

Mailing address

174 Forest Ave
Pearl River, NY 10965-1866
Phone (914) 584-1011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000692 NY Practitioner - Occupational Therapist in Private Practice 9133201981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nysarc Inc Westchester County ChapterGroup PAC ID 1759272206, 9 clinicians
The Epilepsy InstituteGroup PAC ID 0941191381, 6 clinicians

Practice addresses (Care Compare)

265 Saw Mill River Rd
FL 3
Hawthorne, NY 10532-1509
Phone (914) 495-4487

322 8TH Ave
Suite 202
New York, NY 10001-6852
Phone 212677855011

40 Exchange PL
Suite 1700
New York, NY 10005-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013134NYMDChiropractor
013134-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Epilepsy Institute CurrentSince Jul 16, 2019 Accepting new patients
Nysarc Inc Westchester County Chapter CurrentSince Mar 27, 2017 Accepting new patients
The Epilepsy Institute PastSince Apr 9, 2024 Accepting new patients

Locations

265 Saw Mill River Rd
Fl 3
Hawthorne, NY 10532
Phone (914) 495-4487

40 Exchange Pl
Ste 1700
New York, NY 10005
Phone (212) 677-8550

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, 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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1609067412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 FOREST AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651866",
            "telephone_number": "914-584-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 FOREST AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651866",
            "telephone_number": "914-584-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGLEY",
        "first_name": "DESMOND",
        "middle_name": "JOESPH",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013134-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.