Active NPI
Justin D. Peterson, MD
- Hospitalist Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- A172800
- Practice address
- 1250 16TH St # C2304
Santa Monica, CA 90404-1249 - Phone
- (310) 319-4698
- Fax
- (310) 319-4908
- NPI assigned
- Mar 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A172800 | CA | |
| Hospitalist Physician | 208M00000X | A172800 | CA | Primary |
Addresses
Primary practice location
1250 16TH St # C2304
Santa Monica, CA 90404-1249
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other practice location 1
757 Westwood Plz # 7501
Los Angeles, CA 90095-2308
Phone (310) 267-9643
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110126883A | Medicaid | MA |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Cooper Medical School of Rowan University, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Medical Plaza
Los Angeles, CA 90095-0001
100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922
1245 16TH St
Santa Monica, CA 90404-1239
200 Medical Plaza
Los Angeles, CA 90095-0001
200 Medical PLZ
Los Angeles, CA 90095-0001
200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403
2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381
757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 267-9643
900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173
Hospital & facility affiliations
- Santa Monica - UCLA Med Ctr & Orthopaedic Hospital
- Ronald Reagan UCLA Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.51 of 100
- Quality
- 79.37
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A172800 | CA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Regents of the University of California | Internal Medicine | Current | Accepting new patients |
| Regents University of California | Internal Medicine | Current | Accepting new patients |
| Regents University of California | Current | Accepting new patients | |
| The Regents of the University of California | Current | Accepting new patients | |
| UC Regents | Past | Accepting new patients | |
| UCLA Medical Group | Internal Medicine | Past | Accepting new patients |
Locations
24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252
File 55737
Los Angeles, CA 90074
757 Westwood Plz
#7501
Los Angeles, CA 90095
Phone (310) 267-9643
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
757 Westwood Plz
Ste 7501
Los Angeles, CA 90095
Phone (310) 267-9643
1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695
1260 15th St
Ste 1501
Santa Monica, CA 90404
Phone (310) 656-1700
2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381
1250 16th St
Ste C2304
Santa Monica, CA 90404
Phone (424) 259-6000
1250 16th St
#C2304
Santa Monica, CA 90404
100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1235107566
-
- Family Medicine Physician
- Santa Monica, CA
- NPI 1710287297
Internal Medicine
-
- Multi-Specialty Clinic/Center
- Santa Monica, CA
- NPI 1316725963
-
- Ambulatory Surgical Clinic/Center
- Valencia, CA
- NPI 1689200305
-
- Adult Development & Aging Psychologist
- Los Angeles, CA
- NPI 1750368999
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1043427248
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1427055839
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1902803315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1285165472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 16TH ST # C2304",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904041249",
"telephone_number": "310-319-4698",
"fax_number": "310-319-4908"
}
],
"practiceLocations": [
{
"address_1": "757 Westwood Plz # 7501",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900952308",
"country_code": "US",
"telephone_number": "310-267-9643",
"fax_number": "310-267-3840",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "JUSTIN",
"middle_name": "D.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-21",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A172800",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "A172800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110126883A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.