Active NPI
Anjelica Peacock, MD
- Dermatology Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 330446
- Practice address
- 214 Sullivan St
New York, NY 10012-1354 - Phone
- (212) 385-3700
- NPI assigned
- Apr 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 330446 | NY | Primary |
| General Practice Physician | 208D00000X | 35.142051 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
214 Sullivan St
New York, NY 10012-1354
Mailing address
214 Sullivan St
New York, NY 10012-1354
Phone (212) 385-3700
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Wayne State University School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
220 Front St
New York, NY 10038-2033
Phone (212) 385-3700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330446 | NY | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Derm Specs of PA PLLC | Single Specialty | Current | Accepting new patients |
| Bobby Buka, M.D., P.C. | Single Specialty | Current | Accepting new patients |
| Atlas Infectious Disease Practice PLLC | Single Specialty | Past | Accepting new patients |
| Mount Sinai Hospital | Past | Accepting new patients | |
| Out East Medical | Single Specialty | Past | Accepting new patients |
Locations
3179 Steinway St
Astoria, NY 11103
1163 Myrtle Ave
Brooklyn, NY 11206
625 10th Ave
New York, NY 10036
214 Sullivan St
New York, NY 10012
2121 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (718) 534-8190
1425 2nd Ave
New York, NY 10021
3531 Long Beach Rd
Oceanside, NY 11572
Interoperability endpoints
- https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/BFCDAA
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.
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
dba The Dermatology Specialists
- Dermatology Physician
- Oceanside, NY
- NPI 1730757311
Single Specialty
-
- Infectious Disease Physician
- Atlantis, FL
- NPI 1326655846
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770249600000",
"number": "1831651710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 SULLIVAN ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100121354",
"telephone_number": "212-385-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 SULLIVAN ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100121354",
"telephone_number": "212-385-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "ANJELICA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-01",
"last_updated": "2026-02-05",
"certification_date": "2026-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "NY",
"license": "330446",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "OH",
"license": "35.142051",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.