Warren Mark Peluso, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

042-0010097 Issued in VT

Practice address

Parton HC
Middlebury College 5110
Middlebury, VT 05753

Phone

(804) 443-5135

Fax

(802) 443-2066

NPI assigned

Mar 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659402485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PARTON HC",
            "address_2": "MIDDLEBURY COLLEGE 5110",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "05753",
            "telephone_number": "804-443-5135",
            "fax_number": "802-443-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARTON HC",
            "address_2": "MIDDLEBURY COLLEGE 5110",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "05753",
            "telephone_number": "804-443-5135",
            "fax_number": "802-443-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELUSO",
        "first_name": "WARREN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VT",
            "license": "042-0010097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "042-0010097",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Middlebury, VT
• Providers in Middlebury, VT by specialty
• Sports Medicine (Family Medicine) Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.