Active NPI
Peter Thomas Pacik, M.D.
- Plastic Surgery Physician
- Manchester, NH
National Provider Identifier
1861621443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 4674
- Practice address
- 57 Bay St
Manchester, NH 03104-3005 - Phone
- (603) 669-0290
- Fax
- (603) 669-4040
- NPI assigned
- Jul 5, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 4674 | NH | Primary |
Addresses
Primary practice location
57 Bay St
Manchester, NH 03104-3005
Mailing address
57 Bay St
Manchester, NH 03104-3005
Phone (603) 669-0290
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4674 | NH | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plastic Surgery PA | Plastic Surgery | 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": "1246752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1861621443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 BAY ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031043005",
"telephone_number": "603-669-0290",
"fax_number": "603-669-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 BAY ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031043005",
"telephone_number": "603-669-0290",
"fax_number": "603-669-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACIK",
"first_name": "PETER",
"middle_name": "THOMAS",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-05",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NH",
"license": "4674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.