Peter A Michaelson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6047 Issued in CT

Practice address

150 Hazard Ave
Enfield, CT 06082-4575

Phone

(860) 749-0212

Fax

(860) 749-2189

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1497876882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824575",
            "telephone_number": "860-749-0212",
            "fax_number": "860-749-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824575",
            "telephone_number": "860-749-0212",
            "fax_number": "860-749-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELSON",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen D Menyfield, LPC
• Melanie Merritt
• Emily Mew
• Michael P Bernstein MD LLC
• Michael P. Bernstein, MD
• Katherine Michaud
• Shanece R Mifflin
• Martine Mikell
• Alicia Miller, LPC
• John Miller, MPT

• General Practice Dentistry in Enfield, CT
• Providers in Enfield, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.