Active NPI
Peter David Tannous, FNP-C
- Family Nurse Practitioner
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95028977
- Practice address
- 4829 Clairemont Dr
San Diego, CA 92117-2706 - Phone
- (866) 389-2727
- NPI assigned
- Feb 6, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95028977 | CA | Primary |
Addresses
Primary practice location
4829 Clairemont Dr
San Diego, CA 92117-2706
Mailing address
4829 Clairemont Dr
San Diego, CA 92117-2706
Phone (866) 389-2727
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4829 Clairemont Dr
San Diego, CA 92117-2706
Phone (866) 389-2727
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95028977 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Maestra Family Clinic, Inc. | Current | Accepting new patients | |
| La Maestra Family Clinic, Inc. | Current | Accepting new patients | |
| La Maestra Family Clinic Inc. | Current | Accepting new patients | |
| Housecall Doctors Medical Group Inc | Current | Accepting new patients |
Locations
165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347
3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053
4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155
Interoperability endpoints
- peter.tannous.1@14940.direct.athenahealth.com
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.
-
- Family Nurse Practitioner
- El Cajon, CA
- NPI 1568659233
-
- Geriatric Medicine (Family Medicine) Physician
- Long Beach, CA
- NPI 1033164017
-
- Federally Qualified Health Center (FQHC)
- El Cajon, CA
- NPI 1306929443
-
- Family Nurse Practitioner
- Irvine, CA
- NPI 1083421614
-
- Health Service Clinic/Center
- El Cajon, CA
- NPI 1740881085
-
- Federally Qualified Health Center (FQHC)
- El Cajon, CA
- NPI 1568209773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771286400000",
"number": "1205690773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4829 CLAIREMONT DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921172706",
"telephone_number": "866-389-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4829 CLAIREMONT DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921172706",
"telephone_number": "866-389-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNOUS",
"first_name": "PETER",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-06",
"last_updated": "2026-02-17",
"certification_date": "2026-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95028977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.