Individual provider Active NPI

Cornelia Peckman, MD

  • Anesthesiology Physician
  • Short Hills, NJ
National Provider Identifier
1922087360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA05580400 Issued in NJ
Practice address
32 Sparta Rd
Short Hills, NJ 07078-1331
Phone
(973) 564-8063
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA05580400 NJ Primary

Addresses

Primary practice location

32 Sparta Rd
Short Hills, NJ 07078-1331

Mailing address

32 Sparta Rd
Short Hills, NJ 07078-1331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050204000655 NJ Practitioner - Anesthesiology 4385536622 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Jan 4, 2021 Accepting new patients
Summit Anesthesia Associates PA Anesthesiology Past Accepting new patients
North Fullerton Anesthesia, P.C. Anesthesiology Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Organizations & group practices 3

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922087360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SPARTA RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SPARTA RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781331",
            "telephone_number": "973-564-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKMAN",
        "first_name": "CORNELIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA05580400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Short Hills, NJ

Sources for this page

Verify at the official NPI Registry.