Organization Active NPI

Todd W. Peters MD, Inc. a Medical Corporation

  • Orthopaedic Surgery of the Spine Physician
  • Irvine, CA
National Provider Identifier
1689912610
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G88762 Issued in CA
Legal business name
TODD W. PETERS MD, INC. A MEDICAL CORPORATION
Practice address
15785 Laguna Canyon Rd Ste 125
Irvine, CA 92618-3140
Phone
(949) 383-4182
Fax
(949) 383-4183
NPI assigned
Jan 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Authorized official

Name
Todd W. Peters, MDNPI 1316943129
Title
President
Phone
(949) 383-4182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X G88762 CA Primary

Addresses

Primary practice location

15785 Laguna Canyon Rd Ste 125
Irvine, CA 92618-3140

Mailing address

15785 Laguna Canyon Rd Ste 125
Irvine, CA 92618-3140
Phone (949) 383-4182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130308000230 CA Part B Supplier - Clinic/Group Practice 0446405864 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

16405 Sand Canyon Ave
Ste 200
Irvine, CA 92618
Phone (949) 383-4190

3353 Michelson Dr
Ste 400
Irvine, CA 92612

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1689912610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15785 LAGUNA CANYON RD STE 125",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183140",
            "telephone_number": "949-383-4182",
            "fax_number": "949-383-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15785 LAGUNA CANYON RD STE 125",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183140",
            "telephone_number": "949-383-4182",
            "fax_number": "949-383-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD W. PETERS MD, INC. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-383-4182",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G88762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.