Keerti Kirun Peterson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R5795 Issued in TX

Practice address

801 E Whitestone Blvd Ste C
Cedar Park, TX 78613

Phone

(512) 259-3467

Fax

(512) 406-7303

NPI assigned

Apr 29, 2013

Last updated

Mar 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Keerti Kirun Nangia Former name

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

Specialty

Pediatric Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpeterson20266@arcmd.direct-ci.com

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.

• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Austin Regional Clinic, PA

  dba ARC- Center Street

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1235746413
  NPD
• University of California Irvine

  dba UCI Family Health Center - Anaheim

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1598790529
  NPD (past)
• University of California Irvine

  dba Uci Health

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1760827117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HIGHWAY 290 STE 240",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WHITESTONE BLVD STE C",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "78613",
            "telephone_number": "512-259-3467",
            "fax_number": "512-406-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KEERTI",
        "middle_name": "KIRUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R5795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382843601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382843602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEERTI",
            "last_name": "NANGIA",
            "middle_name": "KIRUN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emma C Perry, APRN, PMHNP-BC
• Amanda Persaud
• Personal Living Solutions LP
• Callie Nicole Peters, DC
• Shari Lynette Petersen, APRN, FNP-BC
• Tabitha Peterson
• Adelina Petrova, DENTIST D.M.D.
• Yonatan Pevzner, DDS
• Hong-Ngoc Pham
• Toai Cong Pham, D.D.S.

• Pediatrics Physician in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.