Peter D Shelton, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

000426 2 Issued in NY

Practice address

325 Meeting House LN BLDG 2
Suite 301
Southampton, NY 11968-5087

Phone

(631) 287-9477

NPI assigned

Jul 11, 2006

Last updated

Mar 20, 2008By 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 names 1

• Hampton Orthopedics Sports Medicine Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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.

• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1023043890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MEETING HOUSE LN BLDG 2",
            "address_2": "SUITE 301",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685087",
            "telephone_number": "631-287-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MEETING HOUSE LN BLDG 2",
            "address_2": "SUITE 301",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685087",
            "telephone_number": "631-287-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "000426 1",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "000426 2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAMPTON",
            "last_name": "SPORTS MEDICINE",
            "middle_name": "ORTHOPEDICS",
            "credential": "GROUP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Pedro Ramiro Segarra, MD
• Barbara Marie Seifert, LCSW
• Dianne Sena, MSW
• Danielle Seraile, PSYD
• Jacqueline Anne Shaw, PA-C
• Jeffrey Marc Sherwood, M.D.
• Riddhish Sheth, MD
• Sally Shukry, DO
• Robert James Sicurelli Jr., AB.DDS
• Scott Silverberg

• Surgical Physician Assistant in Southampton, NY
• Providers in Southampton, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.