Individual provider Active NPI

Annette Perea, M.D.

  • Pediatrics Physician
  • Elmhurst, NY
National Provider Identifier
1811913452
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
225537 Issued in NY
Practice address
4008 Forley St
Elmhurst, NY 11373-1427
Phone
(718) 446-0270
Fax
(718) 446-5939
NPI assigned
Jul 15, 2006
Last updated
Jun 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 225537 NY Primary

Addresses

Primary practice location

4008 Forley St
Elmhurst, NY 11373-1427

Mailing address

4008 Forley Street
Elmhurst, NY 11373-1493
Phone (718) 446-0270

Other identifiers 1

IdentifierTypeStateIssuer
02356572MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240327000886 FL Practitioner - Pediatric Medicine 6800049115 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225537NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
9317 Medical Office PC Pediatrics CurrentSince Mar 1, 2024 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

2645 SW 37th Ave
Ste 701
Miami, FL 33133
Phone (305) 476-0025

4008 Forley St
Flushing, NY 11373
Phone (718) 446-0270

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJCIAA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1811913452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 FORLEY STREET",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731493",
            "telephone_number": "718-446-0270",
            "fax_number": "718-446-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 FORLEY ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731427",
            "telephone_number": "718-446-0270",
            "fax_number": "718-446-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREA",
        "first_name": "ANNETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "225537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02356572",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.