Jessica Laine Peatross, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

139872 Issued in CA

Practice address

670 Monterey Pass Rd
Suite 100
Monterey Park, CA 91754-2436

Phone

(626) 551-5155

NPI assigned

Mar 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• After Hour Care of Kentuckiana, Inc.

  • Urgent Care Clinic/Center
  • Jeffersontown, KY
  • NPI 1417001629
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1689704074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MONTEREY PASS RD",
            "address_2": "SUITE 100",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542436",
            "telephone_number": "626-551-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 MONTEREY PASS RD",
            "address_2": "SUITE 100",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542436",
            "telephone_number": "626-551-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEATROSS",
        "first_name": "JESSICA",
        "middle_name": "LAINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "42752",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "139872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO/NIS",
            "identifier": "107156",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NIS/ANTHEM",
            "identifier": "000000624958",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NIS/HUMANA",
            "identifier": "000026447Q",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP/NIS",
            "identifier": "50025070",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seon Ji Park, MFC
• Won Woo Park, D.C
• Adela Marie Partida
• Patrick C E Paik MD Med Corp
• Zoe Paulson
• Pediatric Therapy Partners Inc
• Pen H. Lee, M.D., Inc
• Jorge A Pena, M.D.
• Brian Tim Peng, OTR/L
• Hui Fang B. Peng, L.AC.

• General Practice Physician in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.