Active NPI
Adelqui Osvaldo Peralta, MD
- Clinical Cardiac Electrophysiology Physician
- West Roxbury, MA
National Provider Identifier
1710094222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 215690
- Practice address
- 1400 VFW Pkwy
West Roxbury, MA 02132-4927 - Phone
- (857) 203-6860
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 215690 | MA | Primary |
Addresses
Primary practice location
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Mailing address
17 Clearwater Rd
Chestnut Hill, MA 02467-3706
Phone (617) 325-3167
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215690 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710094222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 CLEARWATER RD",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024673706",
"telephone_number": "617-325-3167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 VFW PKWY",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021324927",
"telephone_number": "857-203-6860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERALTA",
"first_name": "ADELQUI",
"middle_name": "OSVALDO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "MA",
"license": "215690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Roxbury, MA
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.