Individual provider Active NPI

James R Peri, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1801874250
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
145511-1 Issued in NY
Practice address
2882 W 15TH St
Lower Level
Brooklyn, NY 11224-2770
Phone
(718) 837-0010
Fax
(718) 837-1411
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 145511-1 NY Primary

Addresses

Primary practice location

2882 W 15TH St
Lower Level
Brooklyn, NY 11224-2770

Mailing address

2882 W 15TH St
Lower Level
Brooklyn, NY 11224-2770
Phone (718) 837-0010

Other identifiers 1

IdentifierTypeStateIssuer
00595304MedicaidNY

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
I20050722000292 NY Practitioner - Internal Medicine 7315974235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
May accept Medicare assignment
Group practices
Community Health Initiatives, Inc.Group PAC ID 6709185408, 23 clinicians

Practice addresses (Care Compare)

1419 Mermaid Ave
Brooklyn, NY 11224-2615
Phone (718) 210-3110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145511-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Initiatives, Inc. CurrentSince Apr 4, 2016 Accepting new patients
Forest Hills Nuclear Spect Imaging PC Past Accepting new patients
Rockland Nuclear Spect Imaging, P.C. Past Accepting new patients
Heartbeat Medical, PC Past Accepting new patients
Brooklyn Nuclear Spect Imaging, PC Internal Medicine Past Accepting new patients

Locations

1419 Mermaid Ave
Brooklyn, NY 11224
Phone (718) 210-3110

Networks

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

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/cybermed_chi

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1801874250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 W 15TH ST",
            "address_2": "LOWER LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242770",
            "telephone_number": "718-837-0010",
            "fax_number": "718-837-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2882 W 15TH ST",
            "address_2": "LOWER LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242770",
            "telephone_number": "718-837-0010",
            "fax_number": "718-837-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERI",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "145511-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00595304",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.