Individual provider Active NPI

Robert J. Schaffer, P.A.

  • Medical Physician Assistant
  • Fort Pierce, FL
National Provider Identifier
1689770182
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102231 Issued in FL
Practice address
1505 Delaware Ave
Fort Pierce, FL 34950-3975
Phone
(772) 461-1402
Fax
(772) 461-9795
NPI assigned
Sep 15, 2006
Last updated
May 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102231 FL Primary

Addresses

Primary practice location

1505 Delaware Ave
Fort Pierce, FL 34950-3975

Mailing address

4450 S Tiffany Dr
West Palm Beach, FL 33407-3241
Phone (561) 844-9443

Other identifiers 1

IdentifierTypeStateIssuer
292551600MedicaidFL

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1689770182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 S TIFFANY DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073241",
            "telephone_number": "561-844-9443",
            "fax_number": "561-844-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 DELAWARE AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349503975",
            "telephone_number": "772-461-1402",
            "fax_number": "772-461-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFER",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292551600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.