Individual provider Active NPI

Shannon Caesar-Peterson, DO

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1598294241
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
322086 Issued in NY
Practice address
628 Eldert LN Apt 5J
Brooklyn, NY 11208-3371
Phone
(718) 924-0570
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 322086 NY Primary

Addresses

Primary practice location

628 Eldert LN Apt 5J
Brooklyn, NY 11208-3371

Mailing address

628 Eldert LN Apt 5J
Brooklyn, NY 11208-3371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250917004609 NY Practitioner - Osteopathic Manipulative MedicinePractitioner - General Surgery 4688178163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: General Surgery
Education
Touro Un Col of Osteopathic Medicine, New York, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1283 York Ave
New York, NY 10065-5662
Phone (212) 746-2962

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jul 12, 2025 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 12, 2025 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

525 E 68th St
#585
New York, NY 10065
Phone (212) 746-2059

525 E 68th St
Rm L706
New York, NY 10065

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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 5

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1598294241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 ELDERT LN APT 5J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 ELDERT LN APT 5J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083371",
            "telephone_number": "718-924-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAESAR-PETERSON",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "322086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.