Individual provider Active NPI

Peter Michael Loomer, D.D.S.

  • Periodontics
  • San Francisco, CA
National Provider Identifier
1508082819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
SP198 Issued in CA
Practice address
707 Parnassus Avenue
Box 0762
San Francisco, CA 94903-0762
Phone
(415) 476-1731
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X SP198 CA Primary

Addresses

Primary practice location

707 Parnassus Avenue
Box 0762
San Francisco, CA 94903-0762

Mailing address

521 Parnassus Ave. C628
Box 0650
San Francisco, CA 94903-5004
Phone (415) 502-7896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP198CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF School of Dentistry Periodontics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ploomer60946@direct.utmsa.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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508082819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 PARNASSUS AVE. C628",
            "address_2": "BOX 0650",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "949035004",
            "telephone_number": "415-502-7896",
            "fax_number": "415-502-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PARNASSUS AVENUE",
            "address_2": "BOX 0762",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "949030762",
            "telephone_number": "415-476-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMER",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "SP198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.