Look up the most recent NPI and PECOS records

Nicole Peduto

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

Based on the most recent information from CMS, provider Nicole Peduto is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1225548852
Provider Type
Individual
Full Name
Peduto, Nicole
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
10/10/2017
Last Updated
3/14/2019

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9000

Unlisted Fax

Mailing Location

103 Hickory Ave, Staten Island, NY 10305-4415

(347) 885-0374

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 022061 New York

Nicole Peduto

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Castro, Cecilia R

Serino, Jessica

Calcutta, Samantha

Russo, James Vincent

Pope-Lydon, Annette

Compton, Korrine A

Hanna, Catherine

Olinsky, Melanie

Efendija, Betim

Weitzner, Esther