Individual provider Active NPI

Edward John Peters, M.D.

  • Allergy & Immunology Physician
  • Austin, TX
National Provider Identifier
1255342184
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
F7045 Issued in TX
Practice address
720 W 34TH St Ste 200
Austin, TX 78705-1211
Phone
(512) 454-5821
Fax
(512) 459-9137
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X F7045 TX Primary

Addresses

Primary practice location

720 W 34TH St Ste 200
Austin, TX 78705-1211

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 1

IdentifierTypeStateIssuer
6A7174OtherTXMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20031107000461 TX Practitioner - Allergy/ImmunologyPractitioner - Internal MedicinePractitioner - Pulmonary Disease 9537072335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine, Pulmonary Disease
Education
University of Texas Medical Branch at Galveston, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners of Texas IncGroup PAC ID 0244486157, 22 clinicians

Practice addresses (Care Compare)

3410 Far W Blvd
Suite 146
Austin, TX 78731-3167
Phone (512) 349-0777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners of Texas, Inc. Allergy & Immunology CurrentSince Oct 1, 2023 Accepting new patients
Allergy Partners of Texas, Inc Allergy & Immunology Current Accepting new patients
Allergy Partners of Texas, Inc Allergy & Immunology CurrentSince Oct 1, 2023 Accepting new patients
Allergy Partners of Texas, Inc. Allergy & Immunology Past Accepting new patients
Allergy Partners of Texas, Inc Allergy & Immunology Past Accepting new patients

Locations

3410 Far West Blvd
Ste 146
Austin, TX 78731
Phone (512) 349-0777

720 W 34th St
Ste 200
Austin, TX 78705
Phone (512) 422-2247

11645 Angus Rd
Ste A1
Austin, TX 78759
Phone (512) 345-7635

760 N Shiloh Rd
Garland, TX 75042
Phone (972) 272-4463

970 Hesters Crossing Rd
Ste 100
Round Rock, TX 78681
Phone (512) 248-8864

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1255342184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W 34TH ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051211",
            "telephone_number": "512-454-5821",
            "fax_number": "512-459-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "F7045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6A7174",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.