Individual provider Active NPI

Marina Perlov, MD

  • Diagnostic Radiology Physician
  • Bayonne, NJ
National Provider Identifier
1790846772
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MA71419 Issued in NJ
Practice address
657 659 Broadway
Bayonne, NJ 07002
Phone
(201) 437-3007
Fax
(201) 437-4070
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MA71419 NJ Primary
Diagnostic Radiology Physician 2085R0202X 2158081 NY

Addresses

Primary practice location

657 659 Broadway
Bayonne, NJ 07002

Mailing address

657 659 Broadway
Bayonne, NJ 07002
Phone (201) 437-3007

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
I20081114000288 NY Practitioner - Diagnostic Radiology 1557392230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA71419NJMDDiagnostic Radiology Physician
2158081NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Shore Medical PC Past Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology PastSince Sep 22, 2008 Accepting new patients
Ae&Ly Ambulatory Endoscopy PLLC PastSince Mar 1, 2010 Accepting new patients
Advanced Diagnostic Medical Services, P.C. Past Accepting new patients
Brooklyn 83Rd St Medical Diagnostic Radiology Past Accepting new patients
Hudson Radiology Center of NJ Past Accepting new patients
Hudson Radiology Center Diagnostic Radiology Past Accepting new patients
Personal Touch Medical Care, P.C. PastSince Aug 13, 1996 Accepting new patients

Organizations & group practices 8

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790846772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 659 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-437-3007",
            "fax_number": "201-437-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 659 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-437-3007",
            "fax_number": "201-437-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLOV",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "MA71419",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2158081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.