Individual provider Active NPI

Peter M Frasca, DMD

  • General Practice Dentistry
  • Beverly, MA
National Provider Identifier
1972640340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12972 Issued in MA
Practice address
109 Dodge St
Beverly, MA 01915-1053
Phone
(978) 927-3966
Fax
(978) 921-9171
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12972 MA Primary

Addresses

Primary practice location

109 Dodge St
Beverly, MA 01915-1053

Mailing address

109 Dodge St
Beverly, MA 01915-1053
Phone (978) 927-3966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150603002746 MA Order and Referring Only - DentistPractitioner - Dentist 1254652142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12972MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Dental Care PC General Practice PastSince Oct 19, 2020 Accepting new patients
Peter M Frasca D.M.D, P.C. General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972640340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151053",
            "telephone_number": "978-927-3966",
            "fax_number": "978-921-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151053",
            "telephone_number": "978-927-3966",
            "fax_number": "978-921-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASCA",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.