Kimberly A Peck, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

33630 Issued in AZ

Practice address

550 Washington St Ste 641
San Diego, CA 92103-2229

Phone

(619) 299-2600

Fax

(619) 299-3923

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

University of Nebraska College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trauma Team Medical Group IncorporatedGroup PAC ID 6002977642, 9 clinicians

On Call Specialists Medical Group of San Diego IncGroup PAC ID 7911395231, 145 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
• UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
• Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpeck27247@scrippshlth.medalliesdirect.net

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.

• On Call Specialists Medical Group of San Diego, Inc.

  • Specialist
  • San Diego, CA
  • NPI 1962175836
  Medicare reassignment Care Compare group NPD
• Trauma Team Medical Group Incorporated

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1417907510
  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072

  Family Medicine

  Medicare reassignment NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891

  Trauma Surgery

  NPD
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • La Jolla, CA
  • NPI 1619108503
  NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD
• Scripps Health

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1881636108
  NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Family Medicine

  NPD (past)

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

• Regents of the University of California

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1184722779
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation
• Sharp Chula Vista Medical Center

  • General Acute Care Hospital
  • Chula Vista, CA
  • NPI 1396728630
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1215018403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST STE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-299-2600",
            "fax_number": "619-299-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST STE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-299-2600",
            "fax_number": "619-299-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "33630",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "33630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "954075",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Viacheslav Pecherskiy, M.D.
• Annalyn Pecjo Baysa
• Jill A. Peck-Murray, OTR
• Stephanie Peck-Wheeler, PHARM.D.
• Jamin Daniel Peck
• Marti Ellen Peck, MARTI PECK, PH.D.
• Stephanie Knatz Peck, PH.D.
• Beth Ann Peckham, L.AC.
• Maggie Peddicord, RD RDN
• Monica Lea Peddicord, CADC-II

• Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.

Verify at the official NPI Registry.