Individual provider Active NPI

Alan Reed Perestam, D.C.

  • Chiropractor
  • Owego, NY
National Provider Identifier
1831397033
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005926-1 Issued in NY
Practice address
159B McMaster St
Owego, NY 13827-1336
Phone
(607) 687-0800
Fax
(607) 687-3942
NPI assigned
Jul 10, 2007
Last updated
Jan 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005926-1 NY Primary

Addresses

Primary practice location

159B McMaster St
Owego, NY 13827-1336

Mailing address

159B McMaster St
Owego, NY 13827-1336
Phone (607) 687-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111201000551 NY Practitioner - Chiropractic 5890969877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

159 B McMaster St
Owego, NY 13827-1336
Phone (607) 687-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005926-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Perestam Chiropractic PC Chiropractor CurrentSince Apr 1, 1999 Accepting new patients

Locations

159B McMaster St
Owego, NY 13827
Phone (607) 687-0800

Organizations & group practices 1

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1831397033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159B MCMASTER ST",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138271336",
            "telephone_number": "607-687-0800",
            "fax_number": "607-687-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159B MCMASTER ST",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138271336",
            "telephone_number": "607-687-0800",
            "fax_number": "607-687-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERESTAM",
        "first_name": "ALAN",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005926-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.