Individual provider Active NPI

Jonathan Michael Peterson, MD

  • Ophthalmology Physician
  • San Diego, CA
National Provider Identifier
1124641071
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A196755 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
May 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X A196755 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 57326
Los Angeles, CA 90074-0001

Other practice location 1

200 Lothrop St
Pittsburgh, PA 15213-2536
Phone (412) 647-2345

Other practice location 2

9415 Campus Point Dr
LA Jolla, CA 92093-2536
Phone (800) 926-8273

Other practice location 3

9300 Campus Point Dr
LA Jolla, CA 92037-1300
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240715002189 CA Practitioner - Ophthalmology 3173949252 Reassigns benefits to 1 organization
I20250917001808 NV Practitioner - Ophthalmology 3173949252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadows Healthcare LLCGroup PAC ID 9638468739, 19 clinicians

Practice addresses (Care Compare)

1820 E Desert Inn Rd
Las Vegas, NV 89169-3241
Phone (702) 358-0472

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196755CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadows Healthcare LLC CurrentSince Sep 3, 2025 Accepting new patients
Regents of the University of California Ophthalmology CurrentSince Jun 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Jun 1, 2024 Accepting new patients
Curry PLLC PastSince Apr 1, 2020 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

9415 Campus Point Dr
La Jolla, CA 92093
Phone (619) 543-3000

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

2749 Sunridge Heights Pkwy
Henderson, NV 89052
Phone (702) 568-0686

7106 Smoke Ranch Rd
Ste 120
Las Vegas, NV 89128
Phone (702) 565-4917

7190 Smoke Ranch Rd
Ste 110
Las Vegas, NV 89128
Phone (702) 472-9902

8535 Edna Ave
Las Vegas, NV 89117

5556 S Fort Apache Rd
Las Vegas, NV 89148

1820 E Desert Inn Rd
Las Vegas, NV 89169
Phone (702) 732-2398

6850 N Durango Dr
Ste 214
Las Vegas, NV 89149
Phone (702) 362-7246

5295 S Durango Dr
Ste 102
Las Vegas, NV 89113

5115 Camino Al Norte
North Las Vegas, NV 89031

Organizations & group practices 5

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": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1124641071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lothrop St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132536",
            "country_code": "US",
            "telephone_number": "412-647-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9415 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920932536",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371300",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A196755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.