Peter Elsissy, M.D.

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

A100039 Issued in CA

Practice address

1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704

Phone

(909) 557-1600

Fax

(909) 557-1731

NPI assigned

May 7, 2007

Last updated

Feb 24, 2020By 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 2

Addresses

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

Specialty

Orthopedic Surgery

Education

University of California, Geffen School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

San Bernardino Medical Orthopaedic Group IncGroup PAC ID 9335045228, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Redlands Community Hospital Hospital, Redlands, CA, CCN 050272
• Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245
• San Gorgonio Memorial Hospital Hospital, Banning, CA, CCN 050054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• San Bernardino Medical Orthopaedic Group, Inc.

  dba Arrowhead Orthopaedics

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1336187475
  Medicare reassignment Care Compare group NPD
• San Bernardino Medical Orthopaedic Group, Inc.

  dba Arrowhead Orthopaedics

  • Orthopaedic Surgery Physician
  • Beaumont, CA
  • NPI 1235964537
  NPD
• Community Hospital of San Bernardino

  dba Community Convalescent Center of San Bernardino

  • Pediatric Skilled Nursing Facility
  • San Bernardino, CA
  • NPI 1851395685
  NPD (past)
• Dignity Health

  dba St. Bernardine Medical Center

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  NPD (past)
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)
• Riverside Healthcare System, L.P.

  dba Riverside Community Hospital

  • Rehabilitation Hospital Unit
  • Riverside, CA
  • NPI 1053358010
  NPD (past)
• San Bernardino Medical Orthopaedic Group, Inc.

  dba Arrowhead Orthopaedics

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1114527314
  NPD (past)
• San Bernardino Medical Orthopaedic Group, Inc.

  dba Arrowhead Orthopaedics

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1225239304
  NPD (past)
• San Bernardino Medical Orthopaedic Group, Inc.

  dba Arrowhead Orthopaedics

  • Orthopaedic Surgery Physician
  • Victorville, CA
  • NPI 1710586409
  NPD (past)
• San Gorgonio Memorial Hospital

  • General Acute Care Hospital
  • Banning, CA
  • NPI 1568469997
  NPD (past)

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

• County of San Bernardino

  dba Arrowhead Regional Medical Center

  • General Acute Care Hospital
  • Colton, CA
  • NPI 1720158009
  Care Compare affiliation
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  Care Compare affiliation
• San Gorgonio Memorial Hospital

  • General Acute Care Hospital
  • Banning, CA
  • NPI 1568469997
  Care Compare affiliation

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1629281845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ORANGE TREE LN STE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744587",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 120",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749704",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSISSY",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "CA",
            "license": "A100039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Brice Elliott, PH.D.
• Kate Ellis, RN
• Michelle Ellis, LVN
• Kelleigh Ellison, M.S,, CCC-SLP
• Maria Teresa Ventura Elpedes
• Bethany Skye Elton, LMFT
• Emad Ibrahim, MD, Inc.
• Emelly Rosspencer Licensed Marriage & Family Therapist Inc
• John Thomas Harlow Engelhardt, PSY.D.
• Erin K Engstrom, LPCC

• Adult Reconstructive Orthopaedic Surgery Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.