Individual provider Active NPI

Craig Andrew Peters, M.D.

  • Pediatric Urology Physician
  • Dallas, TX
National Provider Identifier
1720157365
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
Q5901 Issued in TX
Practice address
2350 N. Stemmons Freeway
Suite F4300
Dallas, TX 75207
Phone
(214) 456-2444
Fax
(214) 456-2497
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101239362 VA
Pediatric Urology Physician 2088P0231X Q5901 TX Primary

Addresses

Primary practice location

2350 N. Stemmons Freeway
Suite F4300
Dallas, TX 75207

Mailing address

1935 Medical District Drive
Mail Stop F4.04
Dallas, TX 75235
Phone (214) 456-4677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151029001360 TX Practitioner - Urology 8022065622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239362VAMDUrology Physician
Q5901TXMDPediatric Urology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 15, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 15, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

2350 N Stemmons Fwy
Ste F4300
Dallas, TX 75207
Phone (214) 456-2444

1935 Medical District Dr
Stop F404
Dallas, TX 75235

1935 Medical District Dr
#F404
Dallas, TX 75235

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: cpeters112227@direct.swmed.us

Organizations & group practices 4

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1720157365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DRIVE",
            "address_2": "MAIL STOP F4.04",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75235",
            "telephone_number": "214-456-4677",
            "fax_number": "214-456-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N. STEMMONS FREEWAY",
            "address_2": "SUITE F4300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75207",
            "telephone_number": "214-456-2444",
            "fax_number": "214-456-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CRAIG",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101239362",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "TX",
            "license": "Q5901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.