Peter S.C. De Jager, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

002948 Issued in NY

Practice address

830 Washington St
Watertown, NY 13601-4034

Phone

(315) 785-4000

NPI assigned

Oct 3, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Country Emergency Medical Consultants,PC

  • Emergency Medicine Physician
  • Watertown, NY
  • NPI 1972572295

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1295922334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 ARSENAL ST",
            "address_2": "SUITE 504",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012229",
            "telephone_number": "315-782-2620",
            "fax_number": "315-788-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014034",
            "telephone_number": "315-785-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JAGER",
        "first_name": "PETER",
        "middle_name": "S.C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "002948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Christina Davis, LMSW-LP
• Yvonne Lorelle Davis, NURSE PRACTITIONER I
• Mary Dawley, NP
• Michelle Louise Daye
• Susanne Daye, MD
• Cheryl Dean, LPN
• Daniel S Deblasio, MD
• Nicole M Dececchis
• Devan Meade Decicco, M.A., CCC-SLP
• Ashley Decker, PA

• All providers in Watertown, NY
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.