Individual provider Active NPI

Peter Garfield Shactman, PA-C

  • Surgical Physician Assistant
  • Exeter, NH
National Provider Identifier
1306830153
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0742 Issued in NH
Practice address
3 Alumni Dr Ste 101
Exeter, NH 03833-2122
Phone
(603) 773-9992
Fax
(603) 778-6393
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0742 NH Primary

Addresses

Primary practice location

3 Alumni Dr Ste 101
Exeter, NH 03833-2122

Mailing address

4 Alumni Dr
Exeter, NH 03833-2118
Phone (603) 773-9992

Other identifiers 1

IdentifierTypeStateIssuer
311505MedicaidNH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000490 NH Practitioner - Physician Assistant 5092773580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Core Physicians LLCGroup PAC ID 2769563253, 290 clinicians

Practice addresses (Care Compare)

1 Hampton Rd
Suite A306
Exeter, NH 03833-4848
Phone (603) 929-1195

3 Alumni Dr
Exeter, NH 03833-2122

3 Alumni Dr
Exeter, NH 03833-2123

5 Alumni Dr
Exeter, NH 03833-2128
Phone (603) 580-6457

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0742NHMDPhysical Therapy Assistant
1392MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physicians, LLC CurrentSince Jan 22, 2018 Accepting new patients
Clipper Cardiovascular Associates, Inc Past Accepting new patients

Locations

7 Holland Way
#1
Exeter, NH 03833

3 Alumni Dr
Ste 101
Exeter, NH 03833
Phone (603) 773-9992

4 Alumni Dr
Exeter, NH 03833
Phone (603) 580-7653

5 Alumni Dr
Ste 101
Exeter, NH 03833

3 Alumni Dr
Ste 301
Exeter, NH 03833
Phone (603) 658-1180

Interoperability endpoints

  • Direct secure messaging: pshactman479451@direct.bilh.masshiway.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1306830153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ALUMNI DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332118",
            "telephone_number": "603-773-9992",
            "fax_number": "603-778-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ALUMNI DR STE 101",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332122",
            "telephone_number": "603-773-9992",
            "fax_number": "603-778-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACTMAN",
        "first_name": "PETER",
        "middle_name": "GARFIELD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311505",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.