Peter J Siefken, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

005732 Issued in NY

Practice address

518 Montauk Hwy
Ste 102
Amagansett, NY 11930

Phone

(631) 267-5373

Fax

(631) 267-5376

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

State University of New York at Stony Brook, School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peter.siefken.1@2983.direct.athenahealth.com

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.

• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1801277629
  Medicare reassignment Care Compare group NPD
• Hampton Medical Care LLC

  • Specialist
  • Hampton Bays, NY
  • NPI 1366711830
  Medicare reassignment
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • Levittown, NY
  • NPI 1629226592
  NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1740913763
  NPD

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1144347261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 HAMPTON ROAD",
            "address_2": "STE 201",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-283-1126",
            "fax_number": "631-283-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 MONTAUK HWY",
            "address_2": "STE 102",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "11930",
            "telephone_number": "631-267-5373",
            "fax_number": "631-267-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEFKEN",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "005732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02175175",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marit Molin
• June O'Reilly, D.D.S.
• Erik B Peterson, PT
• Dearmo Venice Ramsay, HHA
• Diane Schade, AGPCNP-BC
• Sports Physical Therapy East, PC
• Vincent John Vigorita, M.D.
• Nina Warner, NP

• Medical Physician Assistant in Amagansett, NY
• Providers in Amagansett, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.