Peter W. Siersma, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

79023 Issued in MA

Practice address

14 Williams St
Williamsburg, MA 01096-9427

Phone

(413) 268-3616

Fax

(413) 268-0337

NPI assigned

Mar 23, 2006

Last updated

Oct 7, 2008By 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 18

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CD Practice Associates, Inc.

  dba Hampshire Orthopedics & Sports Medicine - Physical Therapy-Occupationa

  • Physical Therapist
  • West Hatfield, MA
  • NPI 1700210481
  NPD (past)
• Mass General Brigham Medical Group Western Massachusetts Inc

  dba Cooley Dickinson Medical Group

  • Psychiatry Physician
  • Northampton, MA
  • NPI 1942605373
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1730148149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WILLIAMS ST",
            "address_2": "PO BOX 765",
            "city": "WILLIAMSBURG",
            "state": "MA",
            "postal_code": "010969427",
            "telephone_number": "413-268-3616",
            "fax_number": "413-268-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WILLIAMS ST",
            "city": "WILLIAMSBURG",
            "state": "MA",
            "postal_code": "010969427",
            "telephone_number": "413-268-3616",
            "fax_number": "413-268-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERSMA",
        "first_name": "PETER",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "79023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT-WEST",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "000000008323",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PLAN VISTA",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH AMERICAN PREFERRED",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE/GIC",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HNE",
            "identifier": "16424",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6337318007",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTH DIRECT",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "528959",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "J05149",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTHCARE ALLI",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3005763",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "717459",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSOLIDATED",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "04-3194547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "731026",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "515970",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanno P. Muellner, MD
• Elizabeth Pawlikowski
• Joanna Alise Pheasant, ARNP
• Julie Adams Sanders, CNP
• Elizabeth Schwaiger
• Williamsburg Pharmacy, Inc.
• Williamsburg School District
• Jenifer Zajac

• Internal Medicine Physician in Williamsburg, MA
• Providers in Williamsburg, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.