Shawn Peffall (NPI# 1457318933, PAC ID# 0143419812) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1457318933 |
| PAC ID by PECOS | 0143419812 |
| Professional Enrollment ID | I20110111000697 |
| Full Name | Shawn Peffall |
| Organization Legal Name | MARYLAND FAMILY CARE INC |
| Address |
114 Business Ctr Dr Reisterstown MD 21136-1229 |
| Phone Number | 4108332772 |
| Gender | M |
| Graduation Year | 1998 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 5092629394 |
| Number of Group Practice Members | 94 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210008 | MERCY MEDICAL CENTER INC |
| 210063 | UNIVERSITY OF MARYLAND ST JOSEPH MEDICAL CENTER |
| 210040 | NORTHWEST HOSPITAL CENTER |
| 390046 | YORK HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 7602 Belair Rd, Baltimore, MD 21236-4088 | 4106638100 | MARYLAND FAMILY CARE INC |
| 114 Business Ctr Dr, Reisterstown, MD 21136-1229 | 4108332772 | MARYLAND FAMILY CARE INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | MARYLAND FAMILY CARE INC |
| Physicians | 95 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Keith R Dibenedetto | Nurse Practitioner | Maryland Family Care Inc | 10155 York Rd, Suite 200, Cockeysville, MD 21030-3336 |
| Lindsey J Stanton | Nurse Practitioner | Maryland Family Care Inc | 1734 York Rd, Lutherville, MD 21093-5606 |
| Ayesha Faisal Cheema | Internal Medicine | Maryland Family Care Inc | 6011 University Blvd, Suite 120, Ellicott City, MD 21043-6104 |
| Caitlin M Averill | Nurse Practitioner | Maryland Family Care Inc | 114 Business Ctr Dr, Reisterstown, MD 21136-1229 |
| Sebastian K. John | Internal Medicine | Maryland Family Care Inc | 2801 Hudson St, Baltimore, MD 21224-4998 |
| Chackumkal V Cyriac | Internal Medicine | Maryland Family Care Inc | 7602 Belair Rd, Baltimore, MD 21236-4088 |
| Fausto Aquino | Internal Medicine | Maryland Family Care Inc | 8713 Harford Rd, Baltimore, MD 21234-4650 |
| Gary S Friedman | Internal Medicine | Maryland Family Care Inc | 301 Saint Paul St, Baltimore, MD 21202-2102 |
| Susila Rajakumar | Internal Medicine | Maryland Family Care Inc | 7927 Ritchie Hwy, Glen Burnie, MD 21061-4343 |
| Kathryn Boling | Family Medicine | Maryland Family Care Inc | 1734 York Rd, Lutherville, MD 21093-5606 |
| Street Address |
114 BUSINESS CTR DR |
| City | REISTERSTOWN |
| State | MD |
| Zip | 21136-1229 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caitlin M Averill | Nurse Practitioner | Maryland Family Care Inc | 114 Business Ctr Dr, Reisterstown, MD 21136-1229 |
| Jonathan Kushner | Internal Medicine | Maryland Family Care Inc | 114 Business Ctr Dr, Reisterstown, MD 21136-1229 |
| Karen L Minor | Nurse Practitioner | Maryland Family Care Inc | 114 Business Ctr Dr, Reisterstown, MD 21136-1229 |
| Mara Vucich | Physical Medicine and Rehabilitation | Maryland Spine Center Chartered | 114 Business Ctr Dr, Reisterstown, MD 21136-1229 |
| Hina Ghafoor | Internal Medicine | Maryland Family Care Inc | 114 Business Ctr Dr, Reisterstown, MD 21136-1229 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin G. Bache | Chiropractic | 46 Westminster Rd, Reisterstown, MD 21136-1025 | |
| Jon D Koman | Orthopedic Surgery | Koman Orthopedics and Sports Medicine LLC | 116 Westminister Pike, Suite 100, Reisterstown, MD 21136-1027 |
| Tatyana Reznikov | Physical Medicine and Rehabilitation | 116 Westminster Pike, Suite 106, Reisterstown, MD 21136-1027 | |
| David Alvarado | Physician Assistant | Koman Orthopedics and Sports Medicine LLC | 116 Westminister Pike, Suite 100, Reisterstown, MD 21136-1027 |
| Paul Moroney | Physical Therapy | Koman Orthopedics and Sports Medicine LLC | 116 Westminister Pike, Suite 100, Reisterstown, MD 21136-1027 |
| Michael S Goldman | Diagnostic Radiology | Advanced Radiology Pa | 113 Westminster Pike, Suite 103, Reisterstown, MD 21136-1050 |
| Rebecca L Roller | Diagnostic Radiology | Advanced Radiology Pa | 113 Westminster Pike, Suite 103, Reisterstown, MD 21136-1050 |
| Frederic K Yeganeh | Diagnostic Radiology | Advanced Radiology Pa | 113 Westminster Pike, Suite 103, Reisterstown, MD 21136-1050 |
| Jennifer C Correa-elkins | Clinical Social Worker | Chesapeake Behavioral Health Center, LLC | 217 Main St B, Reisterstown, MD 21136-1213 |
| Elsa Victoria Correa-deleonardo | Nurse Practitioner | Chesapeake Behavioral Health Center, LLC | 217 Main St B, Reisterstown, MD 21136-1213 |
| Find all physicians in zip 21136 | |||
| City | REISTERSTOWN |
| Zip Code | 21136 |
| Specialty | DERMATOLOGY |
| City + Specialty | REISTERSTOWN + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.