Individual provider Active NPI

Steven Peterson, O.D.

  • Optometrist
  • La Mesa, CA
National Provider Identifier
1659331320
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT7554 TPA Issued in CA
Practice address
7090 Parkway Dr
La Mesa, CA 91942-1596
Phone
(619) 286-2810
NPI assigned
Mar 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT7554 TPA CA Primary

Addresses

Primary practice location

7090 Parkway Dr
La Mesa, CA 91942-1596

Mailing address

7090 Parkway Dr
La Mesa, CA 91942-1596

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100426000212 CA Practitioner - Optometry 7719014612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3737 Moraga Ave
Suite A105
San Diego, CA 92117-5458
Phone (858) 273-0619

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
81.78
Promoting interoperability
74
Improvement activities
40
Cost
78.59

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT7554 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John C Pack, O.D. and Beverly Bianes, O.D. Inc Optometrist Past Accepting new patients
Thomas S. Tooma, M.D. a Professional Corporation Past Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1659331320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7090 PARKWAY DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7090 PARKWAY DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421596",
            "telephone_number": "619-286-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT7554 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.