Peninsula Laser Eye Medical Group, Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PENINSULA LASER EYE MEDICAL GROUP, INC

Practice address

1174 Castro St
Suite 100
Mountain View, CA 94040-2568

Phone

(650) 961-2585

Fax

(650) 961-6527

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Daniel J. Beers, M.D.NPI 1578625810

Title

Owner

Phone

(650) 961-2585

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: tel-sawy@lasik2020.intellechartdirect.net
• Direct secure messaging: dbeers@lasik2020.intellechartdirect.net
• Direct secure messaging: jliu@lasik2020.intellechartdirect.net

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel J Beers, M.D.

  • Ophthalmology Physician
  • Mountain View, CA
  • NPI 1578625810
  Medicare reassignment Care Compare group Authorized official
• Aruj Ali, OD

  • Optometrist
  • Campbell, CA
  • NPI 1265174254
  Medicare reassignment Care Compare group NPD
• Tarek El-Sawy, M.D.

  • Ophthalmology Physician
  • Cupertino, CA
  • NPI 1922269083
  Medicare reassignment Care Compare group NPD
• Jeffrey Liu, M.D.

  • Ophthalmology Physician
  • Mountain View, CA
  • NPI 1013145127
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1649332990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 CASTRO ST",
            "address_2": "SUITE 100",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402568",
            "telephone_number": "650-961-2585",
            "fax_number": "650-961-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 CASTRO ST",
            "address_2": "SUITE 100",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402568",
            "telephone_number": "650-961-2585",
            "fax_number": "650-961-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA LASER EYE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "BEERS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-961-2585",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK5784",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093380",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD CA",
            "identifier": "ZZZ05868Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lourdes Pedraza, D.D.S.
• Marquise Peggs
• Peninsula Cardiovascular
• Peninsula Eye Surgery Center LLC
• Peninsula Gastroenterology Medical Group Inc
• Peninsula Laser Eye Optical
• Peninsula Wellness Centre
• Wendy Cristina Perdomo Pena, M.D.
• Dalia Perelman, RD
• Abdaly Perez

• Ophthalmology Physician in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.