Individual provider Active NPI

Paul Gregory Peters, MD

  • Orthopaedic Surgery Physician
  • Beavercreek, OH
National Provider Identifier
1689708596
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35.094078 Issued in OH
Practice address
2587 Commons Blvd
Suite 110
Beavercreek, OH 45431-3841
Phone
(937) 836-3118
Fax
(937) 832-5588
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X D0069815 MD
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 35.094078 OH
Orthopaedic Surgery Physician 207X00000X 35.094078 OH Primary

Addresses

Primary practice location

2587 Commons Blvd
Suite 110
Beavercreek, OH 45431-3841

Mailing address

2587 Commons Blvd
Suite 110
Beavercreek, OH 45431-3841
Phone (937) 836-3118

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ppeters471390@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000756 OH Practitioner - Orthopedic Surgery 6800064148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

2587 Commons Blvd
Suite 110
Beavercreek, OH 45431-3841
Phone (937) 424-5825

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Hope Home Care LLC Home health agency, Miamisburg, OH, CCN 368444
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.094078OHMDOrthopaedic Surgery Physician
D0069815MDMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Orthopaedic Surgery CurrentSince Dec 29, 2022 Accepting new patients

Locations

2587 Commons Blvd
Ste 110
Beavercreek, OH 45431
Phone (937) 424-5825

3359 Kemp Rd
Ste 210
Beavercreek, OH 45431
Phone (937) 424-5825

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1689708596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2587 COMMONS BLVD",
            "address_2": "SUITE 110",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313841",
            "telephone_number": "937-836-3118",
            "fax_number": "937-832-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2587 COMMONS BLVD",
            "address_2": "SUITE 110",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313841",
            "telephone_number": "937-836-3118",
            "fax_number": "937-832-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "PAUL",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MD",
            "license": "D0069815",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "OH",
            "license": "35.094078",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.094078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppeters471390@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2587 Commons Blvd",
            "address_2": "Suite 110",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454313841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2587 Commons Blvd",
            "address_2": "Suite 110",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454313841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.