Individual provider Active NPI

Gary L. Peters, MD

  • Specialist
  • Worcester, MA
National Provider Identifier
1154306108
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
46267 Issued in MA
Practice address
123 Summer Street
Suite 320
Worcester, MA 01608
Phone
(508) 368-3140
Fax
(508) 368-3143
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 46267 MA Primary

Addresses

Primary practice location

123 Summer Street
Suite 320
Worcester, MA 01608

Mailing address

5 Neponset St FL Street2
Worcester, MA 01606-2714
Phone (508) 368-5532

Other identifiers 1

IdentifierTypeStateIssuer
6196101MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050323000443 MA Practitioner - Orthopedic Surgery 5496701492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.23 of 100Reported as group
Quality
56.78
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46267MAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

100 Ter Heun Dr
Falmouth, MA 02540
Phone (508) 457-3501

360 Gifford St
Unit 2B
Falmouth, MA 02540
Phone (508) 540-0200

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

Organizations & group practices 3

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1154306108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-368-5532",
            "fax_number": "508-368-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER STREET",
            "address_2": "SUITE 320",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-368-3140",
            "fax_number": "508-368-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "GARY",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "46267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6196101",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.