Roy Schneiderman, MD
Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Pinehurst, NC
NPI 1104840248 · NPPES record last updated Dec 22, 2011
Key facts
- NPI
- 1104840248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal-Perinatal Medicine Physician 2080N0001X
- License
- 9500713 (NC)
- Practice address
- 655 Lake Dornoch Drive
Pinehurst, NC 28374-7135 - Phone
- (910) 692-2712
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110526000601 | KY | Order and Referring Only - Pediatric Medicine |
4385821495 | |
| I20170105001595 | NC | Order and Referring Only - Pediatric Medicine |
4385821495 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9500713 | NC | MD | Neonatal-Perinatal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 9500713 | NC | Yes |
Addresses
Primary practice location
655 Lake Dornoch Drive
Pinehurst, NC 28374-7135
Mailing address
655 Lake Dornoch Dr
Pinehurst, NC 28374-7135
Phone (910) 692-2712
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N13095 | Medicaid | NC | |
| 8974939 | Medicaid | NC |
Other providers in Pinehurst, NC
- Charles Carr Schirmer
- Catherine Schlaff
- Anna Schmieder
- Angeleque Rae Schmitt
- Harold A Schneider
- Lillian Grace Schnitzer
- Kassandra K Schuhmann
- Harvey Randall Schwartz
- John Marshall Schwarz
- Marc Sciarra
All providers in Pinehurst, NC · Neonatal-Perinatal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.