Individual provider Active NPI

Peter E Nnaemeka, MD

  • Surgery Physician
  • New Rochelle, NY
National Provider Identifier
1699734921
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
145021 Issued in NY
Practice address
140 Lockwood Ave
Suite 204
New Rochelle, NY 10801-4915
Phone
(914) 235-1535
Fax
(914) 235-0584
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 145021 NY Primary
Colon & Rectal Surgery Physician 208C00000X 145021 NY

Addresses

Primary practice location

140 Lockwood Ave
Suite 204
New Rochelle, NY 10801-4915

Mailing address

140 Lockwood Ave
Suite 204
New Rochelle, NY 10801-4915
Phone (914) 235-1535

Other identifiers 1

IdentifierTypeStateIssuer
01008873MedicaidNY

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
I20040923000268 NY Practitioner - General Surgery 7315915717 Reassigns benefits to 4 organizations
Practice locations: New Rochelle, NY

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montefiore Mount Vernon HospitalGroup PAC ID 7810122231, 18 clinicians
Montefiore New Rochelle HospitalGroup PAC ID 0345474706, 62 clinicians

Practice addresses (Care Compare)

12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone (914) 664-8000

16 Guion PL
New Rochelle, NY 10801-5502
Phone (914) 365-4065

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Mount Vernon Hospital CurrentSince Nov 6, 2013 Accepting new patients
Montefiore New Rochelle Hospital CurrentSince Nov 6, 2013 Accepting new patients
Interfaith Professional Physician Services, P.C. Surgery CurrentSince Oct 1, 2015 Accepting new patients
Bedford Stuyvesant Family Health Center, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Bedford Stuyvesant Family Health Center, Inc. CurrentSince Jun 1, 2020 Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1456 Fulton St
Brooklyn, NY 11216
Phone (718) 636-4500

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

140 Lockwood Ave
Ste 204
New Rochelle, NY 10801
Phone (914) 235-1535

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFDFAA

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1699734921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVE",
            "address_2": "SUITE 204",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014915",
            "telephone_number": "914-235-1535",
            "fax_number": "914-235-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVE",
            "address_2": "SUITE 204",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014915",
            "telephone_number": "914-235-1535",
            "fax_number": "914-235-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNAEMEKA",
        "first_name": "PETER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "145021",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "145021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01008873",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.