Individual provider Active NPI

Shaun Daniel Peters, RN

  • General Practice Registered Nurse
  • Rochester, NY
National Provider Identifier
1235089590
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
810557 Issued in NY
Practice address
1000 Elmwood Ave Ste 100
Rochester, NY 14620-3093
Phone
(585) 271-0761
NPI assigned
Jan 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 810557 NY Primary

Addresses

Primary practice location

1000 Elmwood Ave Ste 100
Rochester, NY 14620-3093

Mailing address

255 Stottle Rd
Scottsville, NY 14546-9601
Phone (585) 271-0761

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
810557NYMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1235089590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 STOTTLE RD",
            "city": "SCOTTSVILLE",
            "state": "NY",
            "postal_code": "145469601",
            "telephone_number": "585-271-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELMWOOD AVE STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203093",
            "telephone_number": "585-271-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "SHAUN",
        "middle_name": "DANIEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "810557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.