Garrick Kevin Peterson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9157T Issued in CA

Practice address

141 S Mirage Ave
Lindsay, CA 93247-2541

Phone

(559) 562-4963

Fax

(559) 562-1333

NPI assigned

Jun 21, 2006

Last updated

Mar 24, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altura Centers for HealthGroup PAC ID 9830103449, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: garrick.peterson.p1@direct.altura.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Altura Centers for Health

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
  • NPI 1023011632
  Medicare reassignment Care Compare group NPD
• Altura Centers for Health

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
  • NPI 1346486511
  NPD
• Altura Centers for Health

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
  • NPI 1629835426
  NPD

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1649216235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 928",
            "city": "LINDSAY",
            "state": "CA",
            "postal_code": "932470928",
            "telephone_number": "559-562-4963",
            "fax_number": "559-562-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 S MIRAGE AVE",
            "city": "LINDSAY",
            "state": "CA",
            "postal_code": "932472541",
            "telephone_number": "559-562-4963",
            "fax_number": "559-562-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GARRICK",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9157T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DS0091570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Thuy Nguyen, PHARM.D.
• Raul Ochoa, PT, DPT
• Revelyn Eusebio Odra
• Omni Family Health
• P & a Steele Inc. (Steele's Quality Living)
• Marisa Pontrelli, DMD
• Portable Quality Ultrasound
• Greta Posadas, PA-C
• Yazmin Prado, MA
• Guadalupe Quezada, DDS

• Optometrist in Lindsay, CA
• Providers in Lindsay, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.