Individual provider Active NPI

Peter Steenbergen, MD

  • Diagnostic Radiology Physician
  • Shelton, CT
National Provider Identifier
1669453296
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
025333 Issued in CT
Practice address
3 Enterprise Dr Ste 220
Shelton, CT 06484-4694
Phone
(203) 696-6125
Fax
(203) 696-6130
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 025333 CT Primary

Addresses

Primary practice location

3 Enterprise Dr Ste 220
Shelton, CT 06484-4694

Mailing address

3 Enterprise Dr Ste 220
Shelton, CT 06484-4694
Phone (203) 696-6125

Other identifiers 1

IdentifierTypeStateIssuer
001253335MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025333CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield County Imaging Diagnostic Radiology Past Accepting new patients
Paul a. Aiello, MD, PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1669453296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ENTERPRISE DR STE 220",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844694",
            "telephone_number": "203-696-6125",
            "fax_number": "203-696-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ENTERPRISE DR STE 220",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844694",
            "telephone_number": "203-696-6125",
            "fax_number": "203-696-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEENBERGEN",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "025333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001253335",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.