Individual provider Active NPI

Peter S Hedberg, MD

  • Trauma Surgery Physician
  • Dover, NH
National Provider Identifier
1487745329
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
15300 Issued in NH
Practice address
750 Central Avenue
Suite N
Dover, NH 03820-3434
Phone
(603) 749-2266
Fax
(603) 749-3019
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 15300 NH Primary
Trauma Surgery Physician 2086S0127X 77020 MA
Surgery Physician 208600000X 77020 MA
Surgery Physician 208600000X 15300 NH

Addresses

Primary practice location

750 Central Avenue
Suite N
Dover, NH 03820-3434

Mailing address

750 Central Avenue
Suite N
Dover, NH 03820-3434
Phone (603) 749-2266

Other identifiers 2

IdentifierTypeStateIssuer
32000857MedicaidNH
100248030AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110922000467 MA Practitioner - General Surgery 8224206420 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Thoracic Surgery
Education
University of Arizona College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha'S Vineyard Hospital IncGroup PAC ID 9931166113, shared by 5 NPIs, 150 clinicians
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone 508693041079525

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Martha'S Vineyard Hospital Inc Hospital, Oak Bluffs, MA, CCN 221300
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77020MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Martha'S Vineyard Hospital, Inc. CurrentSince Nov 24, 2022 Accepting new patients
The General Hospital Corporation CurrentSince Sep 1, 2011 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Nov 24, 2022 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Surgery CurrentSince Sep 1, 2011 Accepting new patients
Martha'S Vineyard Hospital, Inc. Current Accepting new patients
Martha'S Vineyard Hospital Surgery Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

Interoperability endpoints

  • Direct secure messaging: hedberg.peter.mgh@direct.partners.masshiway.net

Organizations & group practices 7

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 2

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1487745329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVENUE",
            "address_2": "SUITE N",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-749-2266",
            "fax_number": "603-749-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVENUE",
            "address_2": "SUITE N",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-749-2266",
            "fax_number": "603-749-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDBERG",
        "first_name": "PETER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NH",
            "license": "15300",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MA",
            "license": "77020",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "77020",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "15300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32000857",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100248030A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.