Individual provider Active NPI

Robert Thomas Palac, MD

  • Cardiovascular Disease Physician
  • Lebanon, NH
National Provider Identifier
1891725412
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
8604 Issued in NH
Practice address
1 Medical Center Dr
DHMC Department of Cardiology
Lebanon, NH 03756-1000
Phone
(603) 650-6154
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 8604 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
DHMC Department of Cardiology
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC Department of Cardiology
Lebanon, NH 03756-1000
Phone (603) 650-6154

Other identifiers 2

IdentifierTypeStateIssuer
30006280MedicaidNH
0RE1845MedicaidVT

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1891725412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC DEPARTMENT OF CARDIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC DEPARTMENT OF CARDIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAC",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NH",
            "license": "8604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30006280",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0RE1845",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.