Peter A Peruzzo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD08964 Issued in OR

Practice address

1620 E 12TH St
The Dalles, OR 97058-3213

Phone

(541) 296-9151

Fax

(541) 296-9156

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Mid-Columbia Medical Center

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1225010853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1520",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583213",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583213",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUZZO",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD08964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238485",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicolette Marie Penley, LMT, CA
• Analene Joanne Pentopoulos, M.D.
• Lizeth Yoselin Perez Ochoa
• Robert Ray Perkins, OD
• David S. Perry, D.D.S.
• Elizabeth M Pesco
• Cheyenne Peterson
• James Patrick Petrusich, DOCTOR OF AUDIOLOGY
• Jayme Pettibone
• Jordan Ashley Phelps

• Family Medicine Physician in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.