Walter J Peters, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A50476 Issued in CA

Practice address

233 Christie Dr
Martinez, CA 94553-5713

Phone

(925) 930-3110

Fax

(925) 229-2937

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• East Bay Integrated Care, Inc

  • Home Health Agency
  • Pleasant Hill, CA
  • NPI 1205946555

  CA

  Medicare reassignment

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1104857598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6680 ALHAMBRA AVE",
            "address_2": "#419",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945536105",
            "telephone_number": "925-930-3110",
            "fax_number": "925-229-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 CHRISTIE DR",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945535713",
            "telephone_number": "925-930-3110",
            "fax_number": "925-229-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "WALTER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A504760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A504761",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY/ COUNTY  SAN FRAN.",
            "identifier": "H047",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A504760",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A504761",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deana Perkins, SUDCCIII-CS, CCDS
• Gabriella Perlman, RD, IBCLC
• Laronette Perry
• Kelly Perryman
• Elizabeth Peters, RN
• Daniel S Petersen, CATC
• Nicole Marie Petersen, RD
• Krista Peterson, LCSW
• Irini Petros, MD
• Nadine Grace Peyrucain

• All providers in Martinez, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.