Jared Scott Percyz, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

009801 Issued in CT

Practice address

10 Hunter Ave
Miller Place, NY 11764-2714

Phone

(631) 821-3838

Fax

(631) 821-8022

NPI assigned

Mar 14, 2009

Last updated

Mar 14, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1236988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236988800000",
    "number": "1942441365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HUNTER AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642714",
            "telephone_number": "631-821-3838",
            "fax_number": "631-821-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HUNTER AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642714",
            "telephone_number": "631-821-3838",
            "fax_number": "631-821-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCYZ",
        "first_name": "JARED",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-14",
        "last_updated": "2009-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009801",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054020-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "054020-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Miller Place, NY
• Providers in Miller Place, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2009; 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.