Individual provider Active NPI

David B Peisner, MD

  • Maternal & Fetal Medicine Physician
  • Dubois, PA
National Provider Identifier
1124095443
Registry record updated May 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
MD433961 Issued in PA
Practice address
869 Beaver Drive
Dubois, PA 15801
Phone
(814) 371-6501
Fax
(814) 371-6504
NPI assigned
Mar 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X MD433961 PA Primary

Addresses

Primary practice location

869 Beaver Drive
Dubois, PA 15801

Mailing address

869 Beaver Drive
Dubois, PA 15801
Phone (814) 371-6501

Other identifiers 3

IdentifierTypeStateIssuer
MD433961OtherPASTATE MEDICAL LICENSE
1021144330001MedicaidPA
102114433MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maternal Fetal Medicine of Practice Associates, PA Maternal & Fetal Medicine Past Accepting new patients
Obstetrix Medical Group of Phoenix PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590192000000",
    "number": "1124095443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 BEAVER DRIVE",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "15801",
            "telephone_number": "814-371-6501",
            "fax_number": "814-371-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 BEAVER DRIVE",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "15801",
            "telephone_number": "814-371-6501",
            "fax_number": "814-371-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEISNER",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "PA",
            "license": "MD433961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD433961",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021144330001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102114433",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.