NPIMap

Organization Active NPI

Peninsula Eye Physicians Medical Group,Inc.

  • Ophthalmology Physician
  • San Mateo, CA
National Provider Identifier
1346255064
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PENINSULA EYE PHYSICIANS MEDICAL GROUP,INC.
Practice address
101 S San Mateo Dr
Ste 310
San Mateo, CA 94401-3844
Phone
(650) 342-7474
Fax
(650) 342-9260
NPI assigned
Jul 30, 2006
Last updated
Feb 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Authorized official

Name
Michael J Drinnan, MDNPI 1609883024
Title
President
Phone
(650) 342-7474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

101 S San Mateo Dr
Ste 310
San Mateo, CA 94401-3844

Mailing address

101 S San Mateo Dr
Ste 310
San Mateo, CA 94401-3844
Phone (650) 342-7474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050228000703 CA Part B Supplier - Clinic/Group Practice 9032162292 Receives reassigned benefits from 9 practitioners
Practice locations: San Mateo, CA

National Provider Directory

National Provider Directory

Locations

101 S San Mateo Dr
Ste 310
San Mateo, CA 94401
Phone (650) 235-7522

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1346255064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR",
            "address_2": "STE 310",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013844",
            "telephone_number": "650-342-7474",
            "fax_number": "650-342-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR",
            "address_2": "STE 310",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013844",
            "telephone_number": "650-342-7474",
            "fax_number": "650-342-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA EYE PHYSICIANS MEDICAL GROUP,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "DRINNAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-342-7474",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.