MICHAEL NOEL ALONZO PERALTA (NPI# 1811470628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811470628 |
| Entity Type | Individual |
| Full Name | MICHAEL NOEL ALONZO PERALTA |
| Practice Address |
1 Wahoo Ave Groton CT 06349-2324 |
| Mailing Address |
2982 Ne Loyola St Bremerton WA 98311-4013 |
| Practice Telephone | 8605810090 |
| Mailing Telephone | 6192042496 |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2018-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
1 WAHOO AVE |
| City | GROTON |
| State | CT |
| Zip Code | 06349-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207004 | Matthew Braden Burns Miller | Dentist | 1 Wahoo Ave, Groton, CT 06349 | 2005-10-04 |
| 1063027407 | Jimmy Nazih Suliman | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-09-12 |
| 1790395242 | Duc-nhan Nguyen Pham | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-08-08 |
| 1770112708 | Amanda Kathleen Dobyns | Occupational Therapist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-04-02 |
| 1831732825 | Cody Clark | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-10-22 |
| 1477103059 | Jordan Taylor Rucinski | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-09-16 |
| 1699335372 | Cynthia Daigneault | Counselor | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-06-16 |
| 1942868211 | Cameron Anson Martin | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340 | 2019-06-03 |
| 1104386903 | Zena Sabath | General Practice | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-03-20 |
| 1538636527 | Winston Eugene Young | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434347 | Mvca | Optometrist | Navy Submarine Base New London, Bldg 484, Groton, CT 06349 | 2020-10-12 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1588127575 | Morgan Ross Jones | Student in an Organized Health Care Education/Training Program | Bx 159 Navsubase Nlon, Groton, CT 06349 | 2019-04-08 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1013264423 | Dennis Buenaventura Custodio | Military Health Care Provider | 69 Trout Ave, Naval Undersea Medical Institute, Groton, CT 06349 | 2012-08-06 |
| 1609013549 | Nicolas David Mendoza | Military Health Care Provider | Uss Hawaii (ssn 776), Fpo, AE 06349 | 2009-01-14 |
| 1881843084 | Mark Francis Jarvis | Military Health Care Provider | Nssc Nlon, Bldg 76, Groton, CT 06349 | 2008-09-11 |
| 1780882738 | Michael Nutt | Military Health Care Provider | Bldg 517 Taugtog Ave, Navsubscol, Groton, CT 06349 | 2007-07-10 |
| 1497811343 | Keith Benjamin Hoekman | Nurse Practitioner | 1 Wahoo Dr, Groton, CT 06349 | 2006-12-28 |
| 1881604163 | Christina E Toufexis | Pediatrics | 1 Wahoo Drive, Groton, CT 06349 | 2006-08-09 |
| Find all providers in zip 06349 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1700340106 | Robert Christopher Scalise | Military Health Care Provider | 59 Sequin Dr, Groton, CT 06340-5510 | 2019-01-30 |
| 1386965812 | Kevin Ford Wilson | Military Health Care Provider | 1 Wahoo Ave # 600, Groton, CT 06349-2324 | 2010-06-18 |
| 1043286701 | Meghan Elizabeth Wolf | Military Health Care Provider | 15 Mohegan Rd, Groton, CT 06340-5504 | 2006-02-23 |
| 1427443597 | Luke Beardslee | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06349-2324 | 2015-04-05 |
| 1316264138 | Paul B. Schiowitz | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340-2324 | 2010-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972793487 | Brenda Ariana Garzawilliams | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-07-31 |
| 1639369218 | Duong Hoang Nguyen | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-07-30 |
| 1063614949 | Jacqueline Michelle Harrison | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-06-04 |
| 1962509125 | Lisa A Larrivee | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2006-09-20 |
| 1285732057 | Athena Fried | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2006-09-20 |
| 1396702692 | Lena Shearer | Military Health Care Provider | 15 Mohegan Ave, Michael Hall, New London, CT 06320-8100 | 2006-04-28 |
| 1790751972 | Zachary Chancellor Hagerman | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2006-02-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.