NPIMap

Organization Active NPI

Plastic Surgery PA

  • Ambulatory Surgical Clinic/Center
  • Manchester, NH
National Provider Identifier
1326267154
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
4674 Issued in NH
Legal business name
PLASTIC SURGERY PA
Practice address
57 Bay St
Manchester, NH 03104-3005
Phone
(603) 669-0290
Fax
(603) 669-4040
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Authorized official

Name
Peter Thomas Pacik, MDNPI 1861621443
Title
President
Phone
(603) 669-0290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 4674 NH Primary

Addresses

Primary practice location

57 Bay St
Manchester, NH 03104-3005

Mailing address

57 Bay St
Manchester, NH 03104-3005
Phone (603) 669-0290

National Provider Directory

National Provider Directory

Locations

57 Bay St
Manchester, NH 03104
Phone (603) 669-0290

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1326267154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BAY ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031043005",
            "telephone_number": "603-669-0290",
            "fax_number": "603-669-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BAY ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031043005",
            "telephone_number": "603-669-0290",
            "fax_number": "603-669-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "PACIK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-669-0290",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NH",
            "license": "4674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.