Individual provider Active NPI

Peter D Nierman, M.D.

  • Child & Adolescent Psychiatry Physician
  • Aliso Viejo, CA
National Provider Identifier
1801994769
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
G168746 Issued in CA
Practice address
200 Freedom LN
Aliso Viejo, CA 92656-5876
Phone
(949) 900-8600
Fax
(949) 221-3590
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G168746 CA
Child & Adolescent Psychiatry Physician 2084P0804X G168746 CA Primary

Addresses

Primary practice location

200 Freedom LN
Aliso Viejo, CA 92656-5876

Mailing address

1450 W Long Lake Rd Ste 340
Troy, MI 48098-6330
Phone (248) 905-5091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20061106000583 IL Practitioner - Psychiatry 9739186669

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G168746CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychiatric Solutions, P.C. Psychiatry CurrentSince Jan 9, 2021 Accepting new patients

Locations

200 Freedom Ln
Aliso Viejo, CA 92656
Phone (213) 928-2194

5201 White Ln
Bakersfield, CA 93309
Phone (661) 398-1800

1450 W Long Lake Rd
Ste 340
Troy, MI 48098
Phone (248) 839-5381

Interoperability endpoints

  • Direct secure messaging: pniermanmd22882@uchospital.direct-ci.com

Organizations & group practices 1

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1801994769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 W LONG LAKE RD STE 340",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986330",
            "telephone_number": "248-905-5091",
            "fax_number": "248-905-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FREEDOM LN",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565876",
            "telephone_number": "949-900-8600",
            "fax_number": "949-221-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERMAN",
        "first_name": "PETER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G168746",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G168746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.