Organization Active NPI

Richard Periut MD LLC

  • Specialist
  • Union City, NJ
National Provider Identifier
1801842208
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA68984 Issued in NJ
Legal business name
RICHARD PERIUT MD LLC
Practice address
3701 Park Ave
Union City, NJ 07087-6021
Phone
(201) 440-2222
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Authorized official

Name
Dr. Richard Periut, MDNPI 1720034606
Title
Owner
Phone
(201) 440-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA68984 NJ Primary

Addresses

Primary practice location

3701 Park Ave
Union City, NJ 07087-6021

Mailing address

44 Franklin St
Little Ferry, NJ 07643-1218
Phone (201) 512-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060509000237 NJ Part B Supplier - Clinic/Group Practice 0143231993 Receives reassigned benefits from 1 practitioner
Practice locations: West New York, NJ

National Provider Directory

National Provider Directory

Locations

3701 Park Ave
Union City, NJ 07087
Phone (201) 440-2222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1801842208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 FRANKLIN ST",
            "city": "LITTLE FERRY",
            "state": "NJ",
            "postal_code": "076431218",
            "telephone_number": "201-512-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 PARK AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070876021",
            "telephone_number": "201-440-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD PERIUT MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "PERIUT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-440-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA68984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.