Individual provider Active NPI

Peter C Sheffer, D.M.D.

  • General Practice Dentistry
  • Pittsfield, MA
National Provider Identifier
1841341146
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13582 Issued in MA
Practice address
510 North St
Suite 206
Pittsfield, MA 01201-4111
Phone
(413) 443-6333
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13582 MA Primary

Addresses

Primary practice location

510 North St
Suite 206
Pittsfield, MA 01201-4111

Mailing address

510 North St
Suite 206
Pittsfield, MA 01201-4111
Phone (413) 443-6333

Other identifiers 1

IdentifierTypeStateIssuer
0260797MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151216001578 MA Order and Referring Only - DentistPractitioner - Dentist 5193026185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13582MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1841341146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NORTH ST",
            "address_2": "SUITE 206",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014111",
            "telephone_number": "413-443-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NORTH ST",
            "address_2": "SUITE 206",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014111",
            "telephone_number": "413-443-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFFER",
        "first_name": "PETER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0260797",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.