Eric Otto Shreder, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO3456 Issued in AZ

Practice address

4838 E Baseline Rd
Suite 103
Mesa, AZ 85206-4671

Phone

(480) 926-8000

Fax

(480) 926-3445

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Eric O Shreder DO PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1124232848
  NPD Authorized official

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1982712519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD",
            "address_2": "SUITE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064671",
            "telephone_number": "480-926-8000",
            "fax_number": "480-926-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD",
            "address_2": "SUITE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064671",
            "telephone_number": "480-926-8000",
            "fax_number": "480-926-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREDER",
        "first_name": "ERIC",
        "middle_name": "OTTO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "DO3456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2Z3699",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "973281",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ071-6830",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Shostek, PA-C
• Alicia Marie Shoup, PT
• Brianne Rae Showman, PT, DPT
• Zhanna F Shpitalnik, MD
• SHPS PLLC
• Michelle Roos Shreder, RN
• Shree Ji Corporation (Valley Discount Pharmacy)
• Shreeve Dental LLC
• Blake G Shreeve, DMD
• Derek Shreeve

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.