Individual provider Active NPI

Peter Ehren Sterbutzel, DO

  • Obstetrics & Gynecology Physician
  • Highland, CA
National Provider Identifier
1013356336
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A15614 Issued in CA
Practice address
4240 Highland Ave
Highland, CA 92346-2764
Phone
(909) 864-4700
Fax
(909) 864-4300
NPI assigned
Jun 19, 2013
Last updated
Jul 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 274346-216 NY
Obstetrics & Gynecology Physician 207V00000X 20A15614 CA Primary

Addresses

Primary practice location

4240 Highland Ave
Highland, CA 92346-2764

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170822002737 CA Practitioner - Obstetrics/Gynecology 4486926714 Reassigns benefits to 1 organization
I20210112000667 NY Practitioner - Obstetrics/Gynecology 4486926714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

971 Montauk Hwy
Oakdale, NY 11769-1434
Phone (631) 589-4344

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A15614CAMDObstetrics & Gynecology Physician
274346-216NYMDObstetrics & Gynecology Physician
15614CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Obstetrics & Gynecology CurrentSince Nov 18, 2002 Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Sep 22, 2018 Accepting new patients
South Shore University Hospital Past Accepting new patients
San Bernardino Medical Group Inc Past Accepting new patients

Locations

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

300 Community Dr
Manhasset, NY 11030

971 Montauk Hwy
Oakdale, NY 11769
Phone (631) 589-4344

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: petersterbutzel@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1013356336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 HIGHLAND AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462764",
            "telephone_number": "909-864-4700",
            "fax_number": "909-864-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERBUTZEL",
        "first_name": "PETER",
        "middle_name": "EHREN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "274346-216",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A15614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

Verify at the official NPI Registry.