Eugene R. Pellerin Jr., DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

218574 Issued in NY

Practice address

1 Norton Ave
Oneonta, NY 13820

Phone

(607) 431-5305

Fax

(607) 431-5723

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Gene R Pellerin Jr. Other name

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

Specialty

Emergency Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthcare Partners of Saratoga LTDGroup PAC ID 9739320938, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gpellerin100434@albanymed.direct-ci.com

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

• Healthcare Partners of Saratoga LTD

  • Urgent Care Clinic/Center
  • Malta, NY
  • NPI 1700159613
  Medicare reassignment Care Compare group NPD
• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Emergency Medicine

  Medicare reassignment NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Medicare reassignment
• Medical Services of Suffolk County PC

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1811235724
  NPD

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1659470391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "512-852-5563",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NORTON AVE",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-431-5305",
            "fax_number": "607-431-5723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Tallow Wood Dr",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120652807",
            "country_code": "US",
            "telephone_number": "518-373-4444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "79 Vandenburgh Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121806024",
            "country_code": "US",
            "telephone_number": "518-286-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Norton Ave",
            "address_purpose": "LOCATION",
            "city": "Oneonta",
            "state": "NY",
            "postal_code": "13820",
            "country_code": "US",
            "telephone_number": "607-431-5305",
            "fax_number": "607-431-5723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLERIN",
        "first_name": "EUGENE",
        "middle_name": "R.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "218574",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "218574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02543846",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENE",
            "last_name": "PELLERIN",
            "middle_name": "R",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Lynne Panzarella, FNP
• Francesca Parry, LCSW-R
• Elizabeth Patella
• Megan Payne, MS, CCC-SLP
• Peer Alliance League
• Cherie Perales, DO
• Angela M Perry
• David A Picinich, DC
• Amulya Pingali, FNP
• Cynthia L Ploutz, FNP

• Emergency Medicine Physician in Oneonta, NY
• Providers in Oneonta, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.