Peter DO, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

57607 Issued in CA

Practice address

2350 Buhne St Ste a
Eureka, CA 95501-3205

Phone

(707) 443-4593

NPI assigned

Sep 15, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Merit-based Incentive Payment System (MIPS)

Final score

76.1 of 100Reported as group

Quality

73.66

Promoting interoperability

100

Improvement activities

40

Cost

46.65

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pdo687769@direct.ochin.org

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.

• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Anthem, AZ
  • NPI 1619428851
  NPD (past)

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1801315262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 BUHNE ST STE A",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013205",
            "telephone_number": "707-443-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BUHNE ST STE A",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013205",
            "telephone_number": "707-443-4593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41810 N Venture Dr Unit D136",
            "address_purpose": "LOCATION",
            "city": "Anthem",
            "state": "AZ",
            "postal_code": "850863174",
            "country_code": "US",
            "telephone_number": "480-556-0446",
            "fax_number": "480-556-0447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5555 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064622",
            "country_code": "US",
            "telephone_number": "602-865-5445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2946 E Banner Gateway Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342165",
            "country_code": "US",
            "telephone_number": "480-256-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "PETER",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-15",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6852",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Dillon
• Ijeoma Dinneya-George, BSN, PHN, RN-BC
• Dinsmores Inpatient Services a Medical Corporation
• John Eldred Disiere, M.D.
• Leslie Angela Dixon, RN
• Rebecca Doane Dixon
• Christopher Allen Doane, M.A.
• Robyn Dobbs
• Yvonne Claire Doble
• Christine Cecylia Dobrowolski, D.P.M.

• Physician Assistant in Eureka, CA
• Providers in Eureka, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.