Ilia Peregudov, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Swedesboro, New Jersey. His current practice location is
499 Beckett Rd Ste 202, Swedesboro, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(856) 746-0220.
Ilia Peregudov is licensed to practice in New Jersey (license number 25MA12329600) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1881213932.
Physician's Profile
| Full Name | Ilia Peregudov |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology |
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| Location | 499 Beckett Rd Ste 202, Swedesboro, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1881213932
- Provider Enumeration Date: 04/09/2020
- Last Update Date: 10/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 9739627621
- Enrollment ID: I20240809001563
Medical Identifiers
Medical identifiers for Ilia Peregudov such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1881213932 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 25MA12329600 (New Jersey) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ilia Peregudov allows following entities to bill medicare on his behalf.
| Entity Name | Virtua Medical Group, Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1649226515
PECOS PAC ID: 9830222397
Enrollment ID: O20100804000338 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ilia Peregudov is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ilia Peregudov, MD
301 Lippincott Dr Ste 410,
Marlton, NJ 08053-4197
Ph: () - | Ilia Peregudov, MD
499 Beckett Rd Ste 202,
Swedesboro, NJ 08085-1771
Ph: (856) 746-0220 |
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