Individual provider Active NPI

Cosette Peters

  • Physician Assistant
  • Marina, CA
National Provider Identifier
1265213375
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63146 Issued in CA
Practice address
3130 Del Monte Blvd
Marina, CA 93933-3047
Phone
(831) 883-3330
NPI assigned
Oct 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA63146 CA Primary

Addresses

Primary practice location

3130 Del Monte Blvd
Marina, CA 93933-3047

Mailing address

3620 Woodside Ter
Fremont, CA 94539-8048
Phone (510) 552-0323

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106002153 CA Practitioner - Physician Assistant 5698122133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors on Duty Medical Group, IncGroup PAC ID 2466366703, 64 clinicians

Practice addresses (Care Compare)

1505 Main St
Watsonville, CA 95076-3761
Phone (831) 722-1444

3130 Del Monte Blvd
Marina, CA 93933-3047
Phone (831) 883-3330

615 Ocean St
Santa Cruz, CA 95060-4005
Phone (831) 425-7991

6800 Soquel Dr
Aptos, CA 95003-3225
Phone (831) 662-3611

Merit-based Incentive Payment System (MIPS)

Final score
85.47 of 100Reported as group
Quality
67.19
Promoting interoperability
100
Improvement activities
40
Cost
67.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
63146CAMDPharmacist
PA63146CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: cpeters18757@direct.svmh.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1265213375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 WOODSIDE TER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945398048",
            "telephone_number": "510-552-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 DEL MONTE BLVD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333047",
            "telephone_number": "831-883-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "COSETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

Verify at the official NPI Registry.