Marie Azzu Peloso, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

188138 Issued in NY

Practice address

165 N Village Ave
Suite 215
Rockville Centre, NY 11570-3761

Phone

(516) 536-7200

Fax

(516) 536-7208

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Optum Medical Care, P.C.

  dba CareMount Medical, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Mount Kisco Medical Group

  • Hematology (Internal Medicine) Physician
  • Fishkill, NY
  • NPI 1952356362
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1841290285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE",
            "address_2": "SUITE 215",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703761",
            "telephone_number": "516-536-7200",
            "fax_number": "516-536-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE",
            "address_2": "SUITE 215",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703761",
            "telephone_number": "516-536-7200",
            "fax_number": "516-536-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOSO",
        "first_name": "MARIE",
        "middle_name": "AZZU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "188138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01836819",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena Patchke, PT
• Patchogue Medical PC
• Maulik Mafatlal Patel, M.D.
• Lysa Pegler Morgan
• Vernard C Pelage
• Barbara Pepe
• Brian Andres Pereira, PHARM.D.
• Harriet E. Perlmutter, LCSW
• Robert A Perlmutter, M.D.
• Henry D Perry, M.D.

• Pediatrics Physician in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.