Active NPI
Cody Schaefer
- Pharmacist
- Staten Island, NY
National Provider Identifier
1871969527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 064947
- Practice address
- 1125 Bay St
Staten Island, NY 10305-4930 - Phone
- (718) 273-4998
- NPI assigned
- Aug 18, 2015
- Last updated
- Dec 11, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.298781 | IL | |
| Pharmacist | 183500000X | 064947 | NY | Primary |
Addresses
Primary practice location
1125 Bay St
Staten Island, NY 10305-4930
Mailing address
11707 W Brimfield Jubilee Rd
Princeville, IL 61559-9163
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.298781 | IL | MD | Pharmacist |
| 064947 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1871969527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11707 W BRIMFIELD JUBILEE RD",
"city": "PRINCEVILLE",
"state": "IL",
"postal_code": "615599163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 BAY ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103054930",
"telephone_number": "718-273-4998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAEFER",
"first_name": "CODY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-18",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.298781",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "064947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.