NPIMap

Individual provider Active NPI

Ronald Todd Peterson, DO

  • Emergency Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1477533586
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A7104 Issued in CA
Practice address
2615 Eye St
Bakersfield, CA 93301-2006
Phone
(661) 395-3000
Fax
(661) 323-4703
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A7104 CA Primary

Addresses

Primary practice location

2615 Eye St
Bakersfield, CA 93301-2006

Mailing address

PO Box 82396
Bakersfield, CA 93380-2396
Phone (661) 323-5918

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20040629001252 CA Practitioner - Emergency Medicine 8123004033 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Valley Emergency MedicineGroup PAC ID 7113412560, 26 clinicians

Practice addresses (Care Compare)

465 W Putnam Ave
Porterville, CA 93257-3320
Phone (559) 784-1110

Hospital & facility affiliations

  • Sierra View Medical Center Hospital, Porterville, CA, CCN 050261

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
82.65
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7104CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Medical Group, Inc. Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 28, 2023 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Jan 11, 2022 Accepting new patients
Sunshine Physician Services, PC Emergency Medicine CurrentSince May 5, 2002 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southland Emergency Medical Associates Inc Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Desert Valley Medical Group, Inc. Emergency Medicine CurrentSince Jan 11, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 28, 2023 Accepting new patients
Central Valley Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients
Bakersfield Emergency Medical Corp. Emergency Medicine Past Accepting new patients
Aw Pathology Medical Group, Inc. Past Accepting new patients
Central California Emergency Medicine Physicians Emergency Medicine Past Accepting new patients
Emergency Medical Services Group Emergency Medicine Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

5211 W Goshen Ave
Visalia, CA 93291
Phone (559) 242-6860

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: ronald.petersen.p1@direct.dvmg.nextgenshare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1477533586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82396",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933802396",
            "telephone_number": "661-323-5918",
            "fax_number": "661-323-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 EYE ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012006",
            "telephone_number": "661-395-3000",
            "fax_number": "661-323-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RONALD",
        "middle_name": "TODD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A7104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.