Individual provider Active NPI

Peter D Bekendam, MD

  • Ophthalmology Physician
  • Upland, CA
National Provider Identifier
1740468263
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A95411 Issued in CA
Practice address
555 N 13TH Ave
Upland, CA 91786-4904
Phone
(909) 982-8846
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A95411 CA Primary

Addresses

Primary practice location

555 N 13TH Ave
Upland, CA 91786-4904

Mailing address

555 N 13TH Ave
Upland, CA 91786-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110111000712 CA Practitioner - Ophthalmology 2860681533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Eye Institute a Medical Group IncGroup PAC ID 7911966122, 43 clinicians

Practice addresses (Care Compare)

555 N 13TH Ave
Upland, CA 91786-4904
Phone (909) 982-8846

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
76.08
Promoting interoperability
72
Improvement activities
40
Cost
75.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery407

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95411CAMDOphthalmology Physician

Practice roles (8 of 9)

OrganizationSpecialtyStatusNew patients
Pacific Eye Institute, a Medical Group, Inc. Ophthalmology CurrentSince Dec 27, 2014 Accepting new patients
Beaver Medical Group P C Past Accepting new patients
Richmond E Roeske a Professional Corp Ophthalmology Past Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
PHC-Las Cruces Inc Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

15099 Kamana Rd
Apple Valley, CA 92307

16177 Kamana Rd
Apple Valley, CA 92307
Phone (760) 946-0618

500 E Mountain View St
Barstow, CA 92311
Phone (460) 256-1026

1900 E Washington St
Colton, CA 92324
Phone (909) 825-3425

12442 Limonite Ave
Unit 200
Eastvale, CA 91752
Phone (951) 737-4000

11959 Mariposa Rd
Hesperia, CA 92345
Phone (760) 956-1100

9481 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 937-9230

8112 Milliken Ave
Ste 203
Rancho Cucamonga, CA 91730
Phone (909) 945-3563

41877 Enterprise Cir N
Ste 110
Temecula, CA 92590
Phone (951) 296-2244

555 N 13th Ave
Upland, CA 91786
Phone (909) 982-8846

591 N 13th Ave
Upland, CA 91786
Phone (909) 946-5320

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1740468263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N 13TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N 13TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864904",
            "telephone_number": "909-982-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEKENDAM",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A95411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.