Individual provider Active NPI

Andrea B Schneebaum, MD

  • Rheumatology Physician
  • Derry, NH
National Provider Identifier
1205930872
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
11106 Issued in NH
Practice address
6 Tsienneto Rd
Suite 300
Derry, NH 03038-1584
Phone
(603) 216-0400
Fax
(603) 216-3800
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 11106 NH Primary

Addresses

Primary practice location

6 Tsienneto Rd
Suite 300
Derry, NH 03038-1584

Mailing address

6 Tsienneto Rd
Suite 300
Derry, NH 03038-1584
Phone (603) 216-0400

Other identifiers 1

IdentifierTypeStateIssuer
30201363MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000692 NH Practitioner - Rheumatology 0648262394 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11106NHMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern New Hampshire Internal Medicine Associates, PLLC CurrentSince Oct 18, 2004 Accepting new patients
Parkland Physician Services, Inc. Past Accepting new patients

Locations

6 Tsienneto Rd
Ste 300
Derry, NH 03038
Phone (603) 216-0479

49 Range Rd
#100
Windham, NH 03087

Interoperability endpoints

  • Direct secure messaging: andreaschneebaum@snhima.allscriptsdirect.net

Organizations & group practices 2

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1205930872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "SUITE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "SUITE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEEBAUM",
        "first_name": "ANDREA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NH",
            "license": "11106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201363",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.