Individual provider Active NPI

Steven H Peterson, MD

  • Specialist
  • Sonora, CA
National Provider Identifier
1083774897
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G43320 Issued in CA
Practice address
691 Pauline CT
Sonora, CA 95370-5216
Phone
(209) 532-6961
Fax
(209) 532-0537
NPI assigned
Dec 11, 2006
Last updated
Mar 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G43320 CA Primary

Addresses

Primary practice location

691 Pauline CT
Sonora, CA 95370-5216

Mailing address

691 Pauline CT
Sonora, CA 95370-5216
Phone (209) 532-6961

Other identifiers 2

IdentifierTypeStateIssuer
00G43320MedicaidCA
CQ974ZOtherCASTAFF INDIV PTAN MEDICARE-TEMPLETON/TWIN CITIES COMM HOSP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
71.65
Improvement activities
40
Cost
57.96

Merit-based Incentive Payment System (MIPS)

Final score
53.98 of 100Reported as group
Quality
11.8
Promoting interoperability
74
Improvement activities
0
Cost
82.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43320CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Orion Orthopaedic Trauma, Inc CurrentSince Feb 1, 2014 Accepting new patients
San Joaquin Faculty Medical Group CurrentSince Nov 11, 2023 Accepting new patients
County of San Joaquin CurrentSince Nov 11, 2023 Accepting new patients
County of San Joaquin CurrentSince Nov 11, 2023 Accepting new patients
Delphi OB-GYN Group of Montgomery County LLC Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1335 Coffee Rd
Ste 100
Modesto, CA 95355
Phone (209) 524-4438

Organizations & group practices 6

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1083774897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 PAULINE CT",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705216",
            "telephone_number": "209-532-6961",
            "fax_number": "209-532-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 PAULINE CT",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705216",
            "telephone_number": "209-532-6961",
            "fax_number": "209-532-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEVEN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G43320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G43320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAFF INDIV PTAN MEDICARE-TEMPLETON/TWIN CITIES COMM HOSP",
            "identifier": "CQ974Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.