NPIMap

Individual provider Active NPI

Peter S Desilva, MD

  • Family Medicine Physician
  • Rancho Santa Margarita, CA
National Provider Identifier
1316045636
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A44436 Issued in CA
Practice address
29809 Santa Margarita Pkwy
Suite#300
Rancho Santa Margarita, CA 92688-3613
Phone
(949) 709-5100
Fax
(949) 709-5151
NPI assigned
Sep 20, 2006
Last updated
Nov 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A44436 CA Primary

Addresses

Primary practice location

29809 Santa Margarita Pkwy
Suite#300
Rancho Santa Margarita, CA 92688-3613

Mailing address

29809 Santa Margarita Pkwy
Suite#300
Rancho Santa Margarita, CA 92688-3613
Phone (949) 709-5100

Other identifiers 1

IdentifierTypeStateIssuer
00A444360OtherCABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110330000972 CA Practitioner - Family Practice 7315838703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Physicians Medical CorporationGroup PAC ID 6507757986, 2 clinicians

Practice addresses (Care Compare)

29809 Santa Margarita Pkwy
Suite 300
Rancho Santa Margarita, CA 92688-3614
Phone (949) 709-5100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A44436CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Physicians Medical Corporation Family Medicine CurrentSince Jan 1, 2003 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
Children's Hospital at Mission Past Accepting new patients
Children's Hospital of Orange County Past Accepting new patients

Locations

29809 Santa Margarita Pkwy
Ste 300
Rcho Sta Marg, CA 92688
Phone (949) 709-5100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: peter.desilva.p3@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1316045636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29809 SANTA MARGARITA PKWY",
            "address_2": "SUITE#300",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883613",
            "telephone_number": "949-709-5100",
            "fax_number": "949-709-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29809 SANTA MARGARITA PKWY",
            "address_2": "SUITE#300",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883613",
            "telephone_number": "949-709-5100",
            "fax_number": "949-709-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESILVA",
        "first_name": "PETER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00A444360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

Verify at the official NPI Registry.