Kevin P Shaffer, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD027215E Issued in PA

Practice address

149 W 22ND St
Erie, PA 16502-2804

Phone

(814) 456-5433

Fax

(814) 456-0383

NPI assigned

Oct 27, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Apogee Medical Group of Pennsylvania PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1568633535

  PA

  Medicare reassignment NPD
• Apogee Medical Group of Pennsylvania PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1649227166
  NPD
• Saint Vincent Affiliated Physicians

  • Family Medicine Physician
  • Erie, PA
  • NPI 1831264308
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520640000000",
    "number": "1508856824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 W 22ND ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022804",
            "telephone_number": "814-456-5433",
            "fax_number": "814-456-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 W 22ND ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022804",
            "telephone_number": "814-456-5433",
            "fax_number": "814-456-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2018-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD027215E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00308630",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSU",
            "identifier": "000513295",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Lynn Shaffer
• Danette Shaffer
• Erin E Shaffer, DO
• Jazmyne Shiann Shaffer, PA-C
• Judith Shaffer, MS, LCSW
• Kristen Marguerite Shaffer
• Wade Allan Shaffer, D.C.
• John Paul Shafik, DO, MS, PA-C
• Harshit Shah
• Nirali Shah

• Family Medicine Physician in Erie, PA
• Providers in Erie, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2018; 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.