NPIMap

Individual provider Active NPI

Michael James Peters, MD

  • Surgery Physician
  • Dulles, VA
National Provider Identifier
1629414131
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101275348 Issued in VA
Practice address
24430 Stone Springs Blvd, Suite 215
Dulles, VA 20166-2268
Phone
(703) 858-3200
Fax
(703) 858-3203
NPI assigned
May 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 0101275348 VA Primary

Addresses

Primary practice location

24430 Stone Springs Blvd, Suite 215
Dulles, VA 20166-2268

Mailing address

224-D Cornwall Street, NW, Suite 403
Leesburg, VA 20176-2700
Phone (703) 737-6010

Other identifiers 1

IdentifierTypeStateIssuer
1629414131MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220825003898 VA Practitioner - General Surgery 8729377239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

44055 Riverside Pkwy
Suite 246
Leesburg, VA 20176-5178
Phone (703) 858-3200

Hospital & facility affiliations

  • Stonesprings Hospital Center Hospital, Dulles, VA, CCN 490145
  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101275348VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC Surgery CurrentSince Oct 3, 2022 Accepting new patients
Loudoun Medical Group, PC CurrentSince Oct 3, 2022 Accepting new patients

Locations

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

44055 Riverside Pkwy
Ste 246
Leesburg, VA 20176
Phone (703) 771-7111

24430 Stone Springs Blvd
Ste 215
Sterling, VA 20166
Phone (703) 665-2430

Interoperability endpoints

  • Direct secure messaging: michael.peters@avera.sdhealthlink.net
  • Direct secure messaging: michael.peters@lmg1.eclinicaldirectplus.com

Organizations & group practices 10

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1629414131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762700",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24430 STONE SPRINGS BLVD, SUITE 215",
            "city": "DULLES",
            "state": "VA",
            "postal_code": "201662268",
            "telephone_number": "703-858-3200",
            "fax_number": "703-858-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101275348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629414131",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dulles, VA

Sources for this page

Verify at the official NPI Registry.