Individual provider Active NPI

Dwight H Peterson, P.T.

  • Physical Therapist
  • Santa Barbara, CA
National Provider Identifier
1508972803
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22969 Issued in CA
Practice address
215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone
(805) 681-1761
Fax
(805) 681-1768
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT22969 CA Primary

Addresses

Primary practice location

215 Pesetas LN
Santa Barbara, CA 93110-1416

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070117000372 CA Practitioner - Physical Therapist in Private Practice 4880695873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of California, Geffen School of Medicine, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Bissell Chiropractic Clinic IncGroup PAC ID 5597793323, 5 clinicians
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

1470 E Valley Rd
Suite M
Santa Barbara, CA 93108-1220
Phone (805) 565-5252

215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone (805) 681-7800

470 S Patterson Ave
Santa Barbara, CA 93111-2404

5385 Hollister Ave
BLDG 1
Santa Barbara, CA 93111-2389
Phone (805) 681-7781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT22969CAMDLicensed Psychiatric Technician
22969CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bissell Chiropractic Clinic Inc Physical Therapist CurrentSince Feb 18, 2020 Accepting new patients
Sansum Clinic CurrentSince Jan 3, 2005 Accepting new patients
Sansum Clinic CurrentSince Jan 3, 2005 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients

Locations

4151 Foothill Rd
Santa Barbara, CA 93110
Phone (805) 681-1760

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

1470 E Valley Rd
Ste M
Santa Barbara, CA 93108
Phone (805) 565-5252

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1508972803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PESETAS LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101416",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DWIGHT",
        "middle_name": "H",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.