Luke Christopher Peters, MD
Individual provider Active NPI Pediatrics Physician · Santa Clarita, CA
NPI 1639638679 · NPPES record last updated Oct 16, 2024
Key facts
- NPI
- 1639638679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A179979 (CA)
- Practice address
- 23823 Valencia Blvd Ste 120
Santa Clarita, CA 91355-9509 - Phone
- (661) 253-4971
- Fax
- (612) 534-9726
- NPI assigned
- Mar 19, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210621000588 | CA | Order and Referring Only - Pediatric Medicine |
0749680254 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A179979 | CA | MD | Pediatrics Physician |
Practice roles (5 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of California Irvine | Past | Accepting new patients | |
| Santa Clarita Pediatrics | Pediatrics | Past | Accepting new patients |
| Morris Yen, MD, Inc | Pediatrics | Past | Accepting new patients |
| Henry Mayo Newhall Memorial Hospital | Past | Accepting new patients | |
| Sunanda Reddy Vadapalli, MD, Inc | Pediatrics | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A179979 | CA | Yes |
Addresses
Primary practice location
23823 Valencia Blvd Ste 120
Santa Clarita, CA 91355-9509
Mailing address
23823 Valencia Blvd Ste 120
Valencia, CA 91355-9509
Phone (612) 534-9716
Other providers in Santa Clarita, CA
- Essie Peschong
- Daisy Petcharamuk
- Peter Nicolazzo, M.D., Inc
- Cynthia Peter
- Chad A Peters
- Marcy A Petrique
- Brittani Peyton
- Amanda Diane Pfau
- Dorothy Diane Pfeiffer
- Monica Eileen Phelps
All providers in Santa Clarita, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.