Active NPI
Kevin Jerome Peine, MD
- Internal Medicine Physician
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD2017-0635
- Practice address
- 6644 E Baywood Ave
Banner Baywood Medical Center
Mesa, AZ 85206 - Phone
- (480) 321-3900
- Fax
- (480) 321-3840
- NPI assigned
- Jan 25, 2012
- Last updated
- Apr 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 46381 | AZ | |
| Internal Medicine Physician | 207R00000X | MD2017-0635 | NM | Primary |
| Hospitalist Physician | 208M00000X | 46381 | AZ |
Addresses
Primary practice location
6644 E Baywood Ave
Banner Baywood Medical Center
Mesa, AZ 85206
Mailing address
PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 721556 | Medicaid | AZ | |
| 34150757 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
37000 N Gantzel Rd
San Tan Valley, AZ 85140-7303
Phone (480) 394-4000
Hospital & facility affiliations
- Banner Ironwood Medical Center
- Banner Goldfield Medical Center
- Banner Desert Medical Center
- Banner Gateway Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.7 of 100
- Quality
- 64.97
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 69.88
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46381 | AZ | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Family Medicine | Current | Accepting new patients |
| Apogee Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Presbyterian Healthcare Services | Internal Medicine | Current | Accepting new patients |
| Banner Hospital Based Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Cancer Center Specialists LLC | Current | Accepting new patients | |
| Banner Cancer Center Specialists LLC | Current | Accepting new patients | |
| San Juan Regional Medical Center Inc | Current | Accepting new patients | |
| San Juan Regional Medical Center Inc | Hospitalist | Current | Accepting new patients |
| San Juan Regional Medical Center Inc | Family Medicine | Current | Accepting new patients |
| Apogee Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Banner Hospital Based Physicians Arizona LLC | Current | Accepting new patients |
Locations
2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200
1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285
1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450
101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150
6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000
6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000
807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222
1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000
37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000
1625 N Campbell Ave
Tucson, AZ 85719
1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124
8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011
Organizations & group practices 11
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.
-
- Multi-Specialty Clinic/Center
- San Tan Valley, AZ
- NPI 1275889891
-
- Internal Medicine Physician
- Lake Havasu City, AZ
- NPI 1760652218
-
- Oncology Clinic/Center
- Phoenix, AZ
- NPI 1518253152
-
dba Presbyterian Medical Group
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
Family Medicine
-
dba SJHP Gastroenterology
- Gastroenterology Physician
- Farmington, NM
- NPI 1639662901
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1205883725
-
- Oncology Clinic/Center
- Payson, AZ
- NPI 1588158448
-
- Critical Care Medicine (Internal Medicine) Physician
- Phoenix, AZ
- NPI 1780445171
-
dba Presbyterian Hospital
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
Internal Medicine
-
dba San Juan Regional Hospitalists
- Hospitalist Physician
- Farmington, NM
- NPI 1699938282
-
dba SJHP Family Medicine Farmington
- Family Medicine Physician
- Farmington, NM
- NPI 1710589015
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mesa, AZ
- NPI 1720011810
-
- General Acute Care Hospital
- Gilbert, AZ
- NPI 1699884858
-
- General Acute Care Hospital
- Apache Junction, AZ
- NPI 1932543428
-
- General Acute Care Hospital
- Queen Creek, AZ
- NPI 1124341672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1649541301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6210",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874996210",
"telephone_number": "505-609-2258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6644 E BAYWOOD AVE",
"address_2": "BANNER BAYWOOD MEDICAL CENTER",
"city": "MESA",
"state": "AZ",
"postal_code": "85206",
"telephone_number": "480-321-3900",
"fax_number": "480-321-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEINE",
"first_name": "KEVIN",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-25",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "46381",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NM",
"license": "MD2017-0635",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AZ",
"license": "46381",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "721556",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34150757",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.