Organization Active NPI

Christopher H. Peteros, DPM, LLC

  • Podiatrist
  • Longmeadow, MA
National Provider Identifier
1942794656
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1972 Issued in MA
Legal business name
CHRISTOPHER H. PETEROS, DPM, LLC
Practice address
1200 Converse St Ste 103
Longmeadow, MA 01106-1760
Phone
(413) 567-6860
Fax
(413) 567-1491
NPI assigned
Jun 16, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Christopher Hartley Peteros, DPMNPI 1427035351
Title
President
Phone
(413) 567-6860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 1972 MA Primary

Addresses

Primary practice location

1200 Converse St Ste 103
Longmeadow, MA 01106-1760

Mailing address

1200 Converse St Ste 103
Longmeadow, MA 01106-1760
Phone (413) 567-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181106002732 MA Part B Supplier - Clinic/Group Practice 6507110715 Receives reassigned benefits from 1 practitioner
Practice locations: Longmeadow, MA
O20230407000892 CT Part B Supplier - Clinic/Group Practice 6507110715 Receives reassigned benefits from 1 practitioner
Practice locations: Enfield, CT

National Provider Directory

National Provider Directory

Locations

1200 Converse St
Ste 103
Longmeadow, MA 01106
Phone (413) 567-6860

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1942794656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CONVERSE ST STE 103",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061760",
            "telephone_number": "413-567-6860",
            "fax_number": "413-567-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CONVERSE ST STE 103",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061760",
            "telephone_number": "413-567-6860",
            "fax_number": "413-567-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER H. PETEROS, DPM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "PETEROS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "HARTLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-567-6860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmeadow, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.