Peter M Shutkin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

012542 Issued in CT

Practice address

173 East Avenue
New Canaan, CT 06840

Phone

(203) 972-4255

Fax

(203) 801-2126

NPI assigned

Nov 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598830234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 EAST AVENUE",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "06840",
            "telephone_number": "203-972-4255",
            "fax_number": "203-801-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 EAST AVENUE",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "06840",
            "telephone_number": "203-972-4255",
            "fax_number": "203-801-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTKIN",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "012542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0000121773201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4125199",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ZPZ97",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUSKEY",
            "identifier": "00112542600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC",
            "identifier": "01002542CT02",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9519598002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Schwartz, RD, LD
• Micaela Kristin Scully, LCSW
• Michelle Limantour Seaver, LMFT
• Kahani Shah
• Robin D Sheldon
• Travis J Signer, PT
• Lucas Roger Silva, DPT
• Silver Hill Hospital, Inc
• Silver Hill Therapeutic Services, LLC
• Silvermine Therapy LLC

• Internal Medicine Physician in New Canaan, CT
• Providers in New Canaan, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.