Individual provider Active NPI

Dan W.T. Peters, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1366482994
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME80943 Issued in FL
Practice address
1690 N Monroe St
Tallahassee, FL 32303-5533
Phone
(850) 385-2222
Fax
(850) 385-1844
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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 ME80943 FL Primary

Addresses

Primary practice location

1690 N Monroe St
Tallahassee, FL 32303-5533

Mailing address

1690 N Monroe St
Tallahassee, FL 32303-5533
Phone (850) 385-2222

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060501000155 FL Practitioner - Family Practice 5890705297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patients First Lake Ella Medical Center P aGroup PAC ID 4082760566, 23 clinicians

Practice addresses (Care Compare)

1690 N Monroe St
Tallahassee, FL 32303-5533
Phone (850) 385-2222

Merit-based Incentive Payment System (MIPS)

Final score
50.88 of 100Reported as group
Quality
48.24
Promoting interoperability
0
Improvement activities
30
Cost
83.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME80943FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patients First Lake Ella Medical Center P a Family Medicine CurrentSince Dec 1, 2002 Accepting new patients
Advanced Medical Health Center, Inc PastSince Aug 3, 2009 Accepting new patients
Advanced Medical Health Clinic, LLC Past Accepting new patients

Locations

2907 Kerry Forest Pkwy
Tallahassee, FL 32309
Phone (850) 668-3380

3258 N Monroe St
Tallahassee, FL 32303
Phone (850) 562-2010

3401 Capital Cir NE
Tallahassee, FL 32308
Phone (850) 386-2266

505 Appleyard Dr
Tallahassee, FL 32304
Phone (850) 576-8988

1690 N Monroe St
Tallahassee, FL 32303
Phone (850) 385-2222

1705 Mahan Dr
Tallahassee, FL 32308
Phone (850) 877-7164

1160 Apalachee Pkwy
Tallahassee, FL 32301
Phone (850) 878-8843

590 Lanier Ave W
Fayetteville, GA 30214

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1366482994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035533",
            "telephone_number": "850-385-2222",
            "fax_number": "850-385-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035533",
            "telephone_number": "850-385-2222",
            "fax_number": "850-385-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "DAN",
        "middle_name": "W.T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME80943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.