Eric Matthew Shamansky, MD
Individual provider Active NPI Pediatrics Physician · Plymouth, NH
NPI 1962442269 · NPPES record last updated Jan 10, 2012
Key facts
- NPI
- 1962442269
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 13182 (NH)
- Practice address
- 71 Highland St
Plymouth, NH 03264-1233 - Phone
- (603) 536-3700
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Owned or controlled facilities with NPI records 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Speare Memorial Hospital |
Hospital | Corporate Director | Sep 11, 2023 |
| Plymouth Pediatric and Adolescent Medicine |
Rural health clinic | Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 11, 2023 Sep 11, 2023 Sep 11, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170421000428 | NH | Practitioner - Pediatric Medicine | 9537445895 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13182 | NH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speare Memorial Hospital | Current |
Accepting new patients | |
| Speare Memorial Hospital | Current |
Accepting new patients | |
| Speare Memorial Hospital | Current | Accepting new patients | |
| Speare Memorial Hospital | Current |
Accepting new patients |
Locations
16 Hospital Rd
Plymouth, NH 03264
Phone (603) 238-2229
71 Highland St
Plymouth, NH 03264
Phone (603) 536-3700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13182 | NH | Yes |
Addresses
Primary practice location
71 Highland St
Plymouth, NH 03264-1233
Mailing address
71 Highland Street
Plymouth, NH 03264
Phone (603) 536-3700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30206132 | Medicaid | NH | |
| 1012813 | Medicaid | VT |
Other providers in Plymouth, NH
- Claire Ellen Scigliano
- Cynthia Garner Scrimshaw
- Randall Scroggins
- Andrew William Seefeld
- Sarah Lynn Shadallah
- Ali Margaret Sheehan
- Chance Simonton
- Randall J Sims
- Ian Sindlinger
- Sleepwellandbreathe LLC
All providers in Plymouth, NH · Pediatrics Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.