NPIMap

Organization Active NPI

Jennifer R Peos MD LLC

  • Internal Medicine Physician
  • Livingston, NJ
National Provider Identifier
1922432061
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA068460 Issued in NJ
Legal business name
JENNIFER R PEOS MD LLC
Practice address
349 E Northfield Rd
Suite 210
Livingston, NJ 07039-4802
Phone
(973) 597-1107
Fax
(973) 597-1407
NPI assigned
Aug 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Authorized official

Name
Dr. Jennifer R Peos, MDNPI 1710986195
Title
Owner
Phone
(973) 597-1107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MA068460 NJ Primary

Addresses

Primary practice location

349 E Northfield Rd
Suite 210
Livingston, NJ 07039-4802

Mailing address

349 E Northfield Rd
Suite 210
Livingston, NJ 07039-4802
Phone (973) 597-1107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140111000014 NJ Part B Supplier - Clinic/Group Practice 1658509005 Receives reassigned benefits from 1 practitioner
Practice locations: Livingston, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1922432061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 E NORTHFIELD RD",
            "address_2": "SUITE 210",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394802",
            "telephone_number": "973-597-1107",
            "fax_number": "973-597-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 E NORTHFIELD RD",
            "address_2": "SUITE 210",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394802",
            "telephone_number": "973-597-1107",
            "fax_number": "973-597-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER R PEOS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "PEOS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-597-1107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA068460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.