Active NPI
Peter D. Peng, MD
- Surgery Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME169728
- Practice address
- 2501 N Orange Ave Ste 201
Orlando, FL 32804-4641 - Phone
- (407) 821-3620
- Fax
- (407) 821-3621
- NPI assigned
- Jun 28, 2006
- Last updated
- Oct 21, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME169728 | FL | Primary |
| Surgery Physician | 208600000X | MD036096 | DC | |
| Surgery Physician | 208600000X | A88562 | CA |
Addresses
Primary practice location
2501 N Orange Ave Ste 201
Orlando, FL 32804-4641
Mailing address
275 W Macarthur Blvd
Oakland, CA 94611-5641
Phone (510) 752-1000
Other practice location 1
275 W MacArthur Blvd
Oakland, CA 94611-5641
Phone (510) 752-1000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, FL
- 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
- General Surgery
- Education
- Stanford University School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2501 N Orange Ave
Orlando, FL 32804-4641
2501 N Orange Ave
Suite 586
Orlando, FL 32804-4603
Phone (407) 303-6920
2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700
601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A88562 | CA | MD | Surgery Physician |
| MD036096 | DC | MD | Surgery Physician |
| ME169728 | FL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Surgery | Current | Accepting new patients |
| Florida Hospital Medical Group Inc | Surgery | Current | Accepting new patients |
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| Lucy Webb Hayes National Training School for Deaconsses & Missonaries | Past | Accepting new patients |
Locations
1800 Harrison St
Fl 7
Oakland, CA 94612
275 W MacArthur Blvd
Piedmont, CA 94611
Phone (510) 752-1375
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
2501 N Orange Ave
Ste 201
Orlando, FL 32804
Phone (407) 821-3620
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- ppeng3749106@adventhealth.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba AdventHealth Medical Group
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
Surgery
-
dba Rothman Orthopaedics AdventHealth Medical Group at Minneola
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
-
dba Sibley Memorial Hospital
- Internal Medicine Physician
- Washington, DC
- NPI 1659321180
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Orlando
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
dba AdventHealth Orlando Outreach Laboratory
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1710915160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 W MACARTHUR BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115641",
"telephone_number": "510-752-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 N ORANGE AVE STE 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328044641",
"telephone_number": "407-821-3620",
"fax_number": "407-821-3621"
}
],
"practiceLocations": [
{
"address_1": "275 W MacArthur Blvd",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946115641",
"country_code": "US",
"telephone_number": "510-752-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENG",
"first_name": "PETER",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME169728",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "DC",
"license": "MD036096",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A88562",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "275 W MacArthur Blvd",
"city": "Oakland",
"state": "CA",
"country_code": "US",
"postal_code": "946115641",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.