Individual provider Active NPI

Peter Ronan, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Binghamton, NY
National Provider Identifier
1922065093
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
154048 Issued in NY
Practice address
40 Mitchell Ave
New Horizons
Binghamton, NY 13903
Phone
(607) 762-2255
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 154048 NY Primary

Addresses

Primary practice location

40 Mitchell Ave
New Horizons
Binghamton, NY 13903

Mailing address

58 Lusk St
Johnson City, NY 13790-2541
Phone (607) 763-6293

Other identifiers 1

IdentifierTypeStateIssuer
00899725MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000644 NY Practitioner - Internal MedicinePractitioner - Addiction Medicine 5991999203 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Jan 1, 1999 Accepting new patients
United Medical Associates PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1922065093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 LUSK ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902541",
            "telephone_number": "607-763-6293",
            "fax_number": "607-763-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MITCHELL AVE",
            "address_2": "NEW HORIZONS",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13903",
            "telephone_number": "607-762-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONAN",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NY",
            "license": "154048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00899725",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.