NPIMap

Individual provider Active NPI

Paul S Schaefer, M.D.

  • Diagnostic Radiology Physician
  • Frederick, MD
National Provider Identifier
1194751198
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0029265 Issued in MD
Practice address
67 Thomas Johnson Dr
Suite 4
Frederick, MD 21702-4863
Phone
(301) 607-0444
Fax
(301) 831-4495
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0029265 MD Primary

Addresses

Primary practice location

67 Thomas Johnson Dr
Suite 4
Frederick, MD 21702-4863

Mailing address

4110 Aspen Hill Rd
Suite 200
Rockville, MD 20853-2853
Phone (301) 438-5150

Other identifiers 11

IdentifierTypeStateIssuer
058541600MedicaidMD
007238185MedicaidVA
007238193MedicaidVA
010075327MedicaidVA
010072506MedicaidVA
010871200MedicaidDC
007235038MedicaidVA
007238207MedicaidVA
010075297MedicaidVA
010075343MedicaidVA
010075114MedicaidVA

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
Dimensions Health Corporation Diagnostic Radiology Past Accepting new patients

Organizations & group practices 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1194751198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 ASPEN HILL RD",
            "address_2": "SUITE 200",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208532853",
            "telephone_number": "301-438-5150",
            "fax_number": "301-460-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 THOMAS JOHNSON DR",
            "address_2": "SUITE 4",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024863",
            "telephone_number": "301-607-0444",
            "fax_number": "301-831-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0029265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058541600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007238185",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007238193",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010075327",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010072506",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010871200",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007235038",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007238207",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010075297",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010075343",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010075114",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.