NPIMap

Individual provider Active NPI

Shawn M Peffall, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1457318933
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0057104 Issued in MD
Practice address
7602 Belair Rd
Baltimore, MD 21236-4088
Phone
(410) 663-8100
Fax
(410) 663-8119
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0057104 MD Primary

Addresses

Primary practice location

7602 Belair Rd
Baltimore, MD 21236-4088

Mailing address

PO Box 62026
Baltimore, MD 21264-2026
Phone (410) 659-1553

Other identifiers 2

IdentifierTypeStateIssuer
KF68/610285-01OtherMDBC/BS
970101005MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110111000697 MD Practitioner - Internal MedicinePractitioner - Dermatology 0143419812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

114 Business Ctr Dr
Reisterstown, MD 21136-1229
Phone (410) 833-2772

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

  • Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
  • Medstar Health Home Care Home health agency, Baltimore, MD, CCN 217068
  • Stella Maris, Inc. Home health agency, Timonium, MD, CCN 217072
  • The Johns Hopkins Home Health Services, Inc Home health agency, Baltimore, MD, CCN 217081
  • Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008
  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007

Merit-based Incentive Payment System (MIPS)

Final score
78.67 of 100Reported as individual
Quality
58.32
Promoting interoperability
100
Improvement activities
40
Cost
70.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0057104MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Family Care, Inc. Internal Medicine CurrentSince Jun 1, 2001 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

114 Business Center Dr
Reisterstown, MD 21136
Phone (410) 661-3338

Interoperability endpoints

  • Direct secure messaging: speffallmd6682@direct.mdmercy.com

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 7

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1457318933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62026",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642026",
            "telephone_number": "410-659-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7602 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364088",
            "telephone_number": "410-663-8100",
            "fax_number": "410-663-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEFFALL",
        "first_name": "SHAWN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0057104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "KF68/610285-01",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970101005",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.