Individual provider Active NPI

Edward George Schaeffer, MSPT

  • Specialist
  • Wellesley Hills, MA
National Provider Identifier
1902957186
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4729 Issued in MA
Practice address
18 Priscilla Cir
Wellesley Hills, MA 02481-5311
Phone
(508) 376-2100
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4729 MA Primary

Addresses

Primary practice location

18 Priscilla Cir
Wellesley Hills, MA 02481-5311

Mailing address

PO Box 88
Medfield, MA 02052-0088
Phone (508) 376-2100

Other identifiers 3

IdentifierTypeStateIssuer
37064OtherMAHPHC PROVIDER NUMBER
Y66580OtherMABCBS PROVIDER NUMBER
714390OtherMATUFTS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000440 MA Practitioner - Physical Therapist in Private Practice 1456443050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Priscilla Cir
Wellesley, MA 02481-5311
Phone (508) 376-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4729MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Schaeffer Physical Therapy and Sports Medicine Associates, Inc Specialist CurrentSince Aug 27, 2007 Accepting new patients

Locations

750 Union St
Franklin, MA 02038
Phone (508) 528-3240

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1902957186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020520088",
            "telephone_number": "508-376-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PRISCILLA CIR",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024815311",
            "telephone_number": "508-376-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "EDWARD",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "4729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC PROVIDER NUMBER",
            "identifier": "37064",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "Y66580",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROVIDER NUMBER",
            "identifier": "714390",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.