NPIMap

Individual provider Active NPI

Peter Forrest Oliver, MD

  • Surgery Physician
  • San Andreas, CA
National Provider Identifier
1609812965
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G65894 Issued in CA
Practice address
702 Mountain Ranch Rd
San Andreas, CA 95249
Phone
(209) 754-0870
Fax
(209) 754-0878
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G65894 CA Primary

Addresses

Primary practice location

702 Mountain Ranch Rd
San Andreas, CA 95249

Mailing address

PO Box 636
San Andreas, CA 95249
Phone (209) 754-0870

Other identifiers 1

IdentifierTypeStateIssuer
00G58940MedicaidCA

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
I20040625001103 CA Practitioner - General Surgery 9032194915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
R Franklin University of Med & Sci/Chicago Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

445 S Main St
Angels Camp, CA 95222-9328
Phone (209) 736-0249

680 Guzzi LN
Suite 106
Sonora, CA 95370-5288
Phone (209) 536-5770

Hospital & facility affiliations

  • Adventist Health Sonora Hospital, Sonora, CA, CCN 050335
  • Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332
  • Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
81.74
Promoting interoperability
97
Improvement activities
40
Cost
67.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)19
Mastectomy14
Melanoma (skin cancer) excision16
Removal of tissue1-10
Removal of skin lesions28
Removal or shaving of skin growth15
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G65894CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital CurrentSince Feb 11, 2017 Accepting new patients
Sonora Community Hospital Current Accepting new patients
Sonora Community Hospital CurrentSince Feb 11, 2017 Accepting new patients
Sonora Community Hospital CurrentSince Feb 11, 2017 Accepting new patients
Dameron Hospital Association Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sonora Community Hospital Past Accepting new patients
Mark Twain Medical Center Past Accepting new patients

Locations

702 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 754-0870

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

680 Guzzi Ln
Ste 106
Sonora, CA 95370
Phone (209) 532-2792

680 Guzzi Ln
Ste 201
Sonora, CA 95370
Phone (209) 536-1785

1000 Greenley Rd
Ofc
Sonora, CA 95370
Phone (209) 536-3427

900 Greenley Rd
Ste 922
Sonora, CA 95370
Phone (209) 536-3738

Organizations & group practices 8

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1609812965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "209-754-0870",
            "fax_number": "209-754-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "209-754-0870",
            "fax_number": "209-754-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "PETER",
        "middle_name": "FORREST",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G65894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G58940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Andreas, CA

Sources for this page

Verify at the official NPI Registry.