NPIMap

Individual provider Active NPI

Peter Spelman Halt, M.D.

  • Diagnostic Radiology Physician
  • Mount Shasta, CA
National Provider Identifier
1396740338
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A76207 Issued in CA
Practice address
914 Pine St
Mount Shasta, CA 96067-2143
Phone
(530) 926-9329
Fax
(530) 926-9855
NPI assigned
Jun 16, 2005
Reactivated
Apr 4, 2006
Last updated
Jul 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A76207 CA Primary

Addresses

Primary practice location

914 Pine St
Mount Shasta, CA 96067-2143

Mailing address

PO Box 1086
Yreka, CA 96097-1086
Phone (530) 842-7297

Other identifiers 1

IdentifierTypeStateIssuer
00A762070MedicaidCA

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
I20031204001115 CA Practitioner - Diagnostic Radiology 7012812779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Columbia University College of Physicians and Surgeons, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Shasta Radiology IncGroup PAC ID 2062424583, 5 clinicians

Practice addresses (Care Compare)

1111 N Nagle St
Alturas, CA 96101-3840
Phone (530) 708-8800

914 Pine St
Mount Shasta, CA 96067-2143
Phone (530) 926-6111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
15 of 100Reported as individual
Quality
20
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A76207CAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Shasta Radiology Inc Diagnostic Radiology CurrentSince Jan 1, 2006 Accepting new patients
Siskiyou Hospital, Inc. Past Accepting new patients
Mayers Memorial Hospital District Past Accepting new patients
Last Frontier Healthcare District Diagnostic Radiology Past Accepting new patients
Last Frontier Healthcare District Past Accepting new patients

Locations

1111 N Nagle St
Alturas, CA 96101
Phone (530) 708-8800

914 Pine St
Mount Shasta, CA 96067
Phone (503) 926-6111

543 N Main St
Yreka, CA 96097
Phone (530) 842-7297

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1396740338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960971086",
            "telephone_number": "530-842-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-9329",
            "fax_number": "530-926-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALT",
        "first_name": "PETER",
        "middle_name": "SPELMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A76207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A762070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

Verify at the official NPI Registry.