Active NPI
Bradley Kevin Peck, M.D.
- Orthopaedic Surgery Physician
- Canandaigua, NY
National Provider Identifier
1821039140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 185744
- Practice address
- 229 Parrish St
Suite 100
Canandaigua, NY 14424-1791 - Phone
- (585) 394-1960
- Fax
- (585) 393-9232
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 185744 | NY | Primary |
Addresses
Primary practice location
229 Parrish St
Suite 100
Canandaigua, NY 14424-1791
Mailing address
4970 Wyffels Rd
Canandaigua, NY 14424-8364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 185744 | NY | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1821039140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4970 WYFFELS RD",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144248364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 PARRISH ST",
"address_2": "SUITE 100",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144241791",
"telephone_number": "585-394-1960",
"fax_number": "585-393-9232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "BRADLEY",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NY",
"license": "185744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.