Kyle Martin Peterson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95025769 Issued in CA

Practice address

1050 Linden Ave
Long Beach, CA 90813-3321

Phone

(562) 810-7447

NPI assigned

Jul 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Exer Medical Corporation

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group NPD
• Southern California Emergency Medical Group

  • Emergency Medicine Physician
  • San Pedro, CA
  • NPI 1518588433
  Medicare reassignment NPD

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1760169569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133321",
            "telephone_number": "562-810-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133321",
            "telephone_number": "562-810-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KYLE",
        "middle_name": "MARTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Ann Peters, ACNP-BC
• Matthew Peters
• Gary Mark Petersen, OTD, OTR/L
• Emily Peterson
• Josephine Peterson, CRNA
• Lauren Peterson
• Naomi Peterson
• Reina Elaine Peterson, MS, AMFT, APCC
• Zoe Marie Peterson, MS
• Lee Petrarca, RN, MSN, CEN, FNP-C

• Family Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.

Verify at the official NPI Registry.