Individual provider Active NPI

Pieter R Reppenhagen, PA-C

  • Physician Assistant
  • Salem, NH
National Provider Identifier
1477260701
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2075 Issued in NH
Practice address
16 Pelham Rd Ste 1
Salem, NH 03079-3077
Phone
(978) 794-1946
NPI assigned
Nov 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2075 NH Primary

Addresses

Primary practice location

16 Pelham Rd Ste 1
Salem, NH 03079-3077

Mailing address

575 Turnpike St Ste 11
North Andover, MA 01845-5937
Phone (978) 794-1946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230421001621 MA Practitioner - Physician Assistant 8820453020 Reassigns benefits to 3 organizations
I20230907003551 NH Practitioner - Physician Assistant 8820453020 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

103 Boulder Point Dr
Plymouth, NH 03264-3168
Phone (603) 224-3368

150 Flanders Rd
Westborough, MA 01581-1017
Phone (781) 890-2133

16 Pelham Rd
Suite 1
Salem, NH 03079-3077
Phone (603) 898-2244

323 Lowell St
Andover, MA 01810-4659
Phone (978) 794-1946

62 Brown St
Suite 303
Haverhill, MA 01830-6790
Phone (978) 794-1946

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.33 of 100Reported as group
Quality
45.66
Promoting interoperability
100
Improvement activities
40
Cost
68.76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eone Medical Subsidiary PLLC CurrentSince May 1, 2023 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Apr 6, 2024 Accepting new patients
Eone Medical PLLC CurrentSince Jul 25, 2023 Accepting new patients

Locations

62 Brown St
Ste 303
Haverhill, MA 01830
Phone (978) 556-9060

575 Turnpike St
Ste 11
North Andover, MA 01845
Phone (978) 327-6561

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

103 Boulder Point Dr
Plymouth, NH 03264
Phone (603) 536-1284

16 Pelham Rd
Ste 1
Salem, NH 03079
Phone (603) 898-2244

Interoperability endpoints

  • Direct secure messaging: pieter.reppenhagen.3@26085.direct.athenahealth.com

Organizations & group practices 5

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 4

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": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1477260701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 TURNPIKE ST STE 11",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455937",
            "telephone_number": "978-794-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PELHAM RD STE 1",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030793077",
            "telephone_number": "978-794-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPPENHAGEN",
        "first_name": "PIETER",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

Verify at the official NPI Registry.