Individual provider Active NPI

Emarcia Patrice Peete, M.D.

  • Pediatrics Physician
  • Beloit, WI
National Provider Identifier
1780857508
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
53592 Issued in WI
Practice address
2825 Prairie Ave
Beloit, WI 53511-1844
Phone
(608) 363-5500
NPI assigned
Apr 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 002010 GA
Pediatrics Physician 208000000X 53592 WI Primary

Addresses

Primary practice location

2825 Prairie Ave
Beloit, WI 53511-1844

Mailing address

2519 Galahad Way
Janesville, WI 53548-1499
Phone (608) 352-7009

Other identifiers 1

IdentifierTypeStateIssuer
PEETEEMAOtherWIMERCYCARE INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20091123000101 WI Practitioner - Pediatric Medicine 7618016114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002010GAMDPediatrics Physician
53592WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Oct 19, 2009 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Oct 19, 2009 Accepting new patients
Mercy Health System Corporation PastSince Oct 19, 2009 Accepting new patients
Mercy Health System Corporation Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: epeete5417@direct.mhemail.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1208044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1780857508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 GALAHAD WAY",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535481499",
            "telephone_number": "608-352-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 PRAIRIE AVE",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111844",
            "telephone_number": "608-363-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEETE",
        "first_name": "EMARCIA",
        "middle_name": "PATRICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-13",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "002010",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "53592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "PEETEEMA",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.