Thomas Peterson, DNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95008779 Issued in CA

Practice address

16911 Willow Glen Rd.
Brownsville, CA 95919

Phone

(530) 675-0466

NPI assigned

Nov 18, 2017

Last updated

May 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, AK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iliuliuk Family and Health Services IncGroup PAC ID 5294635165, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Merit-based Incentive Payment System (MIPS)

Final score

87.39 of 100Reported as group

Quality

75.67

Promoting interoperability

100

Improvement activities

40

Cost

74.51

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tpeterson454887@hisp.ehr.sutterhealth.org

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.

• Iliuliuk Family and Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Unalaska, AK
  • NPI 1376520692
  Medicare reassignment Care Compare group NPD
• Altamont Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Tracy, CA
  • NPI 1952392375
  Medicare reassignment NPD
• Los Robles Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Thousand Oaks, CA
  • NPI 1417983552
  Medicare reassignment NPD
• Iliuliuk Family &Health Services, Inc.

  dba IFHS Pharmacy

  • Community/Retail Pharmacy
  • Unalaska, AK
  • NPI 1760340905
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1538673181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "916-708-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16911 WILLOW GLEN RD.",
            "city": "BROWNSVILLE",
            "state": "CA",
            "postal_code": "95919",
            "telephone_number": "530-675-0466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1512 Texas Ave S",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778403385",
            "country_code": "US",
            "telephone_number": "979-213-5728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "554-850 Medical Center Drive",
            "address_purpose": "LOCATION",
            "city": "Bieber",
            "state": "CA",
            "postal_code": "96009",
            "country_code": "US",
            "telephone_number": "530-294-5241",
            "fax_number": "530-294-5132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "923 V St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958181331",
            "country_code": "US",
            "telephone_number": "855-354-2242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-18",
        "last_updated": "2021-05-12",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "NP35008779",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F11170360",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95008779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Caldwell, F.N.P.
• Inderjit Kaur Dhami, NP
• Debora Liz Harrison, RCFE LICENCEE
• Tawnya Irene Hoffman, PA-C
• William G Hoffman, M.D.
• Sutter North Medical Foundation (Sutter North Brownsville Family Practice Center)
• Sutter North Medical Foundation
• Sutter Valley Medical Foundation (Sutter North Brownsville Family Practice Center)
• Ashley Lauren Van Buren, FNP-C

• Family Medicine Physician in Brownsville, CA
• Providers in Brownsville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.