Individual provider Active NPI

Peter J Liepmann, MD

  • Family Medicine Physician
  • Pasadena, CA
National Provider Identifier
1568415701
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C 89383 Issued in CA
Practice address
2319 E Washington Blvd # 2
Pasadena, CA 91104-1945
Phone
(845) 797-0950
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X C 89383 CA
Family Medicine Physician 207Q00000X C 89383 CA Primary

Addresses

Primary practice location

2319 E Washington Blvd # 2
Pasadena, CA 91104-1945

Mailing address

257 S de Lacey Ave Unit 1130
Pasadena, CA 91105-4189
Phone (518) 302-6006

Other practice location 1

257 S De Lacey Ave Unit 1130
Pasadena, CA 91105-4189
Phone (518) 302-6006

Other identifiers 1

IdentifierTypeStateIssuer
00843150MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220914001916 CA Practitioner - Family Practice 4880789692 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159061NYMDDental Hygienist
C 89383CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Urgent Care, Inc. Family Medicine Current Accepting new patients
Anaheim Urgent Care, Inc CurrentSince Jun 1, 2022 Accepting new patients
West Hollywood Urgent Care CurrentSince Jun 1, 2022 Accepting new patients
Keystone Hospitalist Services of New York P.C. Past Accepting new patients
Exigence Hospitalist Medical Services of Hornell, PLLC Past Accepting new patients

Locations

1300 N La Brea Ave
Los Angeles, CA 90028
Phone (323) 464-1336

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

600 S Lake Ave
Ste 105
Pasadena, CA 91106
Phone (626) 572-4000

Interoperability endpoints

  • Direct secure messaging: peter.liepmann.p1@direct.scfhc.nextgenshare.com

Organizations & group practices 5

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1568415701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S DE LACEY AVE UNIT 1130",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911054189",
            "telephone_number": "518-302-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 E WASHINGTON BLVD # 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041945",
            "telephone_number": "845-797-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "257 S De Lacey Ave Unit 1130",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911054189",
            "country_code": "US",
            "telephone_number": "518-302-6006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEPMANN",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "C 89383",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C 89383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00843150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.