Individual provider Active NPI

Walter Lee Shaffer, MD

  • Family Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1790027647
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD008908E Issued in PA
Practice address
309 Surrey PL
Pittsburgh, PA 15235
Phone
(412) 242-0902
NPI assigned
Mar 19, 2013
Last updated
Mar 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD008908E PA Primary

Addresses

Primary practice location

309 Surrey PL
Pittsburgh, PA 15235

Mailing address

309 Surrey PL
Pittsburgh, PA 15235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318001273 PA Order and Referring Only - Family PracticePractitioner - Family Practice 4880991835

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD008908EPAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1790027647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SURREY PL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SURREY PL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15235",
            "telephone_number": "412-242-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "WALTER",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD008908E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.