Michael Blair Peterson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G45972 Issued in CA

Practice address

2500 Merced St
San Leandro, CA 94577-4201

Phone

(510) 454-1000

NPI assigned

Nov 1, 2006

Sex

Male

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: Vascular Surgery

Education

University of California, Davis School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Bay Cardiovascular and Thoracic Associates IncGroup PAC ID 9032290770, 17 clinicians

Cep America - Auc PCGroup PAC ID 9537481692, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Comfort Assisting, Inc Home health agency, Walnut Creek, CA, CCN 059537
• San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689
• John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496
• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
• Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

95.12

Promoting interoperability

100

Improvement activities

40

Cost

78.87

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpeterson147439@ehr.johnmuirhealth.com

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.

• Cep America - Auc PC

  • General Practice Physician
  • Walnut Creek, CA
  • NPI 1568861524
  Medicare reassignment Care Compare group NPD
• East Bay Cardiovascular and Thoracic Associates Inc.

  • Surgery Physician
  • Danville, CA
  • NPI 1073647202
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Surgery

  Medicare reassignment NPD
• Cep America - Auc PC

  • General Practice Physician
  • San Ramon, CA
  • NPI 1750024493

  Surgery

  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531

  Surgery

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Cep America - Auc PC

  • General Practice Physician
  • Newport News, VA
  • NPI 1104657329
  NPD
• California Emergency Physician Medical Group

  • General Practice Physician
  • Walnut Creek, CA
  • NPI 1962791293
  NPD (past)
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• John Muir Health

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  NPD (past)
• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  NPD (past)

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

• Comfort Assisting, Inc.

  • Home Health Agency
  • Walnut Creek, CA
  • NPI 1467778100
  Care Compare affiliation
• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation
• John Muir Health

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  Care Compare affiliation
• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  Care Compare affiliation
• Stanford Health Care Tri-Valley

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1144389941
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1255419024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 EL CAPITAN DR",
            "address_2": "STE 120",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945266260",
            "telephone_number": "925-334-5800",
            "fax_number": "925-689-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHAEL",
        "middle_name": "BLAIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G45972",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G45972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G459720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariana Tavano Peters
• Emily Peters
• Haley Petersen, DDS
• Erin Peterson, MFT
• Kelly Peterson
• Benjamin Allan Petrofsky
• Michael Petruolo, ASW
• Anthony Petty
• Cynthia My Pham
• Mai Tan Pham, CLINICAL SOCIAL WORK

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.