Individual provider Active NPI

Jonathan Schreiber, MD

  • Gynecology Physician
  • Beverly, MA
National Provider Identifier
1740209709
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
56558 Issued in MA
Practice address
83 Herrick St
Suite 2004
Beverly, MA 01915-2757
Phone
(978) 927-4800
Fax
(978) 232-5772
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 56558 MA Primary

Addresses

Primary practice location

83 Herrick St
Suite 2004
Beverly, MA 01915-2757

Mailing address

83 Herrick St
Suite 2004
Beverly, MA 01915-2757
Phone (978) 927-4800

Other identifiers 1

IdentifierTypeStateIssuer
3014240MedicaidMA

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
56558MAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1740209709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 HERRICK ST",
            "address_2": "SUITE 2004",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152757",
            "telephone_number": "978-927-4800",
            "fax_number": "978-232-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HERRICK ST",
            "address_2": "SUITE 2004",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152757",
            "telephone_number": "978-927-4800",
            "fax_number": "978-232-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHREIBER",
        "first_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MA",
            "license": "56558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3014240",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.