Individual provider Active NPI

Peter Lawrence O'Malley, MD

  • Pediatrics Physician
  • Folsom, CA
National Provider Identifier
1821073537
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A066715 Issued in CA
Practice address
1370 Prairie City Rd
Folsom, CA 95630-9554
Phone
(916) 985-9300
NPI assigned
Dec 14, 2005
Last updated
Sep 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A066715 CA Primary

Addresses

Primary practice location

1370 Prairie City Rd
Folsom, CA 95630-9554

Mailing address

1370 Prairie City Rd
Folsom, CA 95630-9554
Phone (916) 985-9300

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
I20040712001564 CA Practitioner - Pediatric Medicine 5496733743 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A066715CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Dec 1, 2022 Accepting new patients
Regents of the University of California CurrentSince May 20, 2008 Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 1, 2022 Accepting new patients
Regents of the University of California CurrentSince May 20, 2008 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

14264 Innovation Dr
Folsom, CA 95630
Phone (916) 946-1700

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2315 Stockton Blvd
#5
Sacramento, CA 95817
Phone (916) 703-3050

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

3160 Folsom Blvd
Ste 2500
Sacramento, CA 95816
Phone (916) 734-5846

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1821073537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 PRAIRIE CITY RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309554",
            "telephone_number": "916-985-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 PRAIRIE CITY RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309554",
            "telephone_number": "916-985-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "PETER",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A066715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.