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DR. PETER J SEBENY M.D.
NPI 1194704932
Internal Medicine - Infectious Disease in Newburyport, MA

Active since January 11, 2006PECOS EnrolledAccepts Medicare Assignment
21 HIGHLAND AVE STE 5, NEWBURYPORT, MA 01950(978) 255-4886(978) 255-4878 Get Directions Write a Review

NPPES record last updated: June 16, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 16, 2021, Jun 9, 2021, Feb 27, 2017 (3 updates tracked since 2017).

About Dr. Peter J Sebeny M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PETER J SEBENY M.D. (NPI 1194704932) is an individual infectious disease provider in Newburyport, Massachusetts, licensed in New Hampshire (15813) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Anna Jaques Hospital, and maintains a secondary practice location in Derry.

NPPES Registry Identity

NPI1194704932
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. PETER J SEBENYCredential: M.D.
Location Address21 HIGHLAND AVE STE 5Newburyport, MA 01950-3873
Mailing Address24 Morrill Pl Ste 2Amesbury, MA 01913-3530 · (978) 834-8074
Phone(978) 255-4886
Fax(978) 255-4878
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 2003
Enumeration DateJanuary 11, 2006
Last NPPES UpdateJune 16, 20213 updates tracked since enumeration
NPPES CertifiedJune 16, 2021
✔ NPI 1194704932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in NH · 15813
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
21 HIGHLAND AVE STE 5, Newburyport, MA 01950
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Secondary Practice Location 1

Location 144 Birch St, Ste 200Derry, NH 03038-2752 · Phone (603) 421-9616 · Fax (603) 421-2451

Other Identifiers 1

Medicaid3081584NH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Peter J Sebeny M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800058660
PECOS Enrollment IDI20180321001471
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
569 services205 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
204 services182 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
118 services111 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
96 services50 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
80 services18 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
66 services40 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Anna Jaques Hospital

Acute Care Hospitals · Newburyport, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220029
Location25 Highland AvenueNewburyport, MA 01950 · Essex County
Emergency services Birthing friendly

Northeast Hospital Corporation

Acute Care Hospitals · Beverly, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220033
Location85 Herrick StreetBeverly, MA 01915 · Essex County
Emergency services Birthing friendly

Beth Israel Deaconess Medical Center

Acute Care Hospitals · Boston, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220086
Location330 Brookline AvenueBoston, MA 02215 · Suffolk County
Emergency services Birthing friendly

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220171
Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County
Emergency services

Parkland Medical Center

Acute Care Hospitals · Derry, NH
5/5 CMS rating
OwnershipProprietary
CMS Certification Number300017
Location1 Parkland DriveDerry, NH 03038 · Rockingham County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01950 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims540 services$0.37 avg. paid by Medicare
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
DME-Medical/Surgical Supplies · category DA023N
2 suppliers14 claims1,582 services$0.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peter Sebeny's NPI number?

The NPI number for Peter Sebeny is 1194704932. It was assigned to this individual provider in the NPPES registry on January 11, 2006.

Where is Peter Sebeny located?

Peter Sebeny practices at 21 Highland Ave Ste 5, Newburyport, MA 01950. The listed phone number is (978) 255-4886.

What is Peter Sebeny's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Peter Sebeny enrolled in Medicare?

Yes. Peter Sebeny is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Peter Sebeny accept?

Health plans from Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Peter Sebeny as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Peter Sebeny affiliated with any hospitals?

According to CMS data, Peter Sebeny is affiliated with Anna Jaques Hospital, Northeast Hospital Corporation, Beth Israel Deaconess Medical Center, Lahey Hospital & Medical Center, Burlington and Parkland Medical Center.

When was this NPI record last updated?

The NPPES record for Peter Sebeny was last updated on June 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.