Robert Eugene Pellegrine, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

379938-1205 Issued in UT

Practice address

2009 Mahre Dr
Park City, UT 84098-8510

Phone

(435) 658-1313

NPI assigned

Mar 19, 2009

Last updated

Mar 19, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Medical Care, PC

  • Internal Medicine Physician
  • Phillipsburg, NJ
  • NPI 1275570418
  NPD (past)

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1942441068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 MAHRE DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840988510",
            "telephone_number": "435-658-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 MAHRE DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840988510",
            "telephone_number": "435-658-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINE",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "379938-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Jean Peacock, M.D.
• Peak Performance Physical Therapy, PC (Peak Performance Sports Medicine)
• Steven Pearmain, PA.C
• Thomas Roger Peay, PH.D.
• Wade A Peers, D.D.S.
• Vannette Perkins, MD
• Kristen Michelle Perlmutter, S.S.W.
• Adam Robert Perreault, MED, ATC
• James Robert Perrone, PTA
• Jesse Perry, M.D.

• Internal Medicine Physician in Park City, UT
• Providers in Park City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.