Active NPI
Mark Alan Peterson, PT
- Orthopedic Physical Therapist
- Vista, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 17962
- Practice address
- 130 Cedar Rd
Vista, CA 92083-5102 - Phone
- (760) 901-5040
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 17962 | CA | Primary |
Addresses
Primary practice location
130 Cedar Rd
Vista, CA 92083-5102
Mailing address
10790 Rancho Bernardo Rd # 4S-305
San Diego, CA 92127-5705
Phone (760) 901-5040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
130 Cedar Rd
Vista, CA 92083-5102
Phone (760) 806-5400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Clinic Medical Group | Past | Accepting new patients | |
| Scripps Health | Past | Accepting new patients |
Locations
9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123
File 54433
Los Angeles, CA 90074
Phone (858) 784-5645
3905 Waring Rd
Oceanside, CA 92056
Phone (760) 477-1350
10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171
10790 Rancho Bernardo Rd
#4S305
San Diego, CA 92127
130 Cedar Rd
Vista, CA 92083
Phone (760) 806-5400
Interoperability endpoints
- mpeterson12385@scrippshlth.medalliesdirect.net
Organizations & group practices 8
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.
-
dba Scripps Hospital Medical Services
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
-
dba Scripps Home Health Care Services
- Home Health Agency
- San Diego, CA
- NPI 1578556114
-
dba Scripps Cardiovascular and Thoracic Surgery Center
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- La Jolla, CA
- NPI 1619108503
-
dba Scripps Memorial Hospital La Jolla
- General Acute Care Hospital
- La Jolla, CA
- NPI 1841277704
-
dba Scripps Coastal Medical Center
- Family Medicine Physician
- San Diego, CA
- NPI 1881636108
-
- Multi-Specialty Clinic/Center
- San Diego, CA
- NPI 1124003280
-
- Clinical Medical Laboratory
- La Jolla, CA
- NPI 1427034990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1093775025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10790 RANCHO BERNARDO RD # 4S-305",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921275705",
"telephone_number": "760-901-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 CEDAR RD",
"city": "VISTA",
"state": "CA",
"postal_code": "920835102",
"telephone_number": "760-901-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MARK",
"middle_name": "ALAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "17962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.