Individual provider Active NPI

Nancy Elizabeth Peterson, FNP-C

  • Family Nurse Practitioner
  • Palm Desert, CA
National Provider Identifier
1104297894
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95002940 Issued in CA
Practice address
72630 Fred Waring Dr
Palm Desert, CA 92260-5003
Phone
(760) 674-1923
Fax
(760) 834-7445
NPI assigned
Oct 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95002940 CA Primary

Addresses

Primary practice location

72630 Fred Waring Dr
Palm Desert, CA 92260-5003

Mailing address

72630 Fred Waring Dr
Palm Desert, CA 92260-5003
Phone (760) 674-1923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160901002576 CA Practitioner - Nurse Practitioner 0648566513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (909) 486-5650

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Emergency Medicine CurrentSince Jun 27, 2016 Accepting new patients
Southern California Emergency Medicine CurrentSince Jun 27, 2016 Accepting new patients
Cep America-California CurrentSince Aug 1, 2016 Accepting new patients
Cep America - California CurrentSince Aug 1, 2016 Accepting new patients
Cep America - California Current Accepting new patients
Desert Vip Urgent Care Past Accepting new patients

Locations

1407 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-3577

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

1295 Hamner Ave
Ste C
Norco, CA 92860
Phone (951) 272-6500

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

33494 Oak Glen Rd
Yucaipa, CA 92399
Phone (909) 797-8900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1104297894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72630 FRED WARING DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922605003",
            "telephone_number": "760-674-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72630 FRED WARING DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922605003",
            "telephone_number": "760-674-1923",
            "fax_number": "760-834-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "NANCY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.