Individual provider Active NPI

Brian Robert Peters, MD

  • Otolaryngology Physician
  • Dallas, TX
National Provider Identifier
1124076062
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G5473 Issued in TX
Practice address
7777 Forest LN
A-103
Dallas, TX 75230-2505
Phone
(972) 566-7600
Fax
(972) 566-6560
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G5473 TX Primary

Addresses

Primary practice location

7777 Forest LN
A-103
Dallas, TX 75230-2505

Mailing address

7777 Forest LN
A-103
Dallas, TX 75230-2505
Phone (972) 566-7600

Other identifiers 2

IdentifierTypeStateIssuer
872112OtherTXBCBS
1012398MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20111216000329 TX Practitioner - Otolaryngology 4486721206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical Branch at Galveston, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas Otolaryngology AssociatesGroup PAC ID 3072647890, 19 clinicians

Practice addresses (Care Compare)

7777 Forest LN
Suite A103
Dallas, TX 75230-6800
Phone (972) 566-7600

Hospital & facility affiliations

  • Legent Surgical Hospital Plano Hospital, Plano, TX, CCN 670322
  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
82.14
Improvement activities
40
Cost
71.2

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Otolaryngology Associates Otolaryngology CurrentSince Dec 1, 1988 Accepting new patients

Locations

7777 Forest Ln
Ste A103
Dallas, TX 75230
Phone (972) 566-7359

4461 Coit Rd
Ste 311
Frisco, TX 75035
Phone (214) 872-2688

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124076062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "A-103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-7600",
            "fax_number": "972-566-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "A-103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-7600",
            "fax_number": "972-566-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRIAN",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "G5473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "872112",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012398",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.