Individual provider Active NPI

John T. Peters, D.O.

  • Pulmonary Disease Physician
  • Bradenton, FL
National Provider Identifier
1376531103
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
OS7555 Issued in FL
Practice address
2401 Manatee Ave W
Bradenton, FL 34205-4933
Phone
(941) 744-1336
Fax
(941) 746-3846
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X OS7555 FL Primary

Addresses

Primary practice location

2401 Manatee Ave W
Bradenton, FL 34205-4933

Mailing address

2401 Manatee Ave W
Bradenton, FL 34205-4933
Phone (941) 744-1336

Other identifiers 1

IdentifierTypeStateIssuer
256226000MedicaidFL

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
I20100913000785 FL Practitioner - Pulmonary Disease 2062459720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matrix Pulmonary, P.a.Group PAC ID 6608813365, 4 clinicians

Practice addresses (Care Compare)

2401 Manatee Ave W
Bradenton, FL 34205-4933
Phone (941) 744-1336

Hospital & facility affiliations

  • Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035
  • HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
93.22
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS7555FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Pulmonary, P.a. Pulmonary Disease CurrentSince Mar 1, 2001 Accepting new patients

Locations

2401 Manatee Ave W
Bradenton, FL 34205
Phone (941) 744-1336

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: johnpeters@mat.ssdirect.aprima.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.

Hospital & facility affiliations 4

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1376531103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054933",
            "telephone_number": "941-744-1336",
            "fax_number": "941-746-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054933",
            "telephone_number": "941-744-1336",
            "fax_number": "941-746-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JOHN",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "OS7555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256226000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.