Individual provider Active NPI

Peter Demerest Vanhouten, M.D.

  • General Practice Physician
  • Nevada City, CA
National Provider Identifier
1841411758
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G43114 Issued in CA
Practice address
15301 Tyler Foote Rd.
Nevada City, CA 95959-9318
Phone
(530) 292-3478
Fax
(530) 292-4296
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G43114 CA Primary

Addresses

Primary practice location

15301 Tyler Foote Rd.
Nevada City, CA 95959-9318

Mailing address

14618 Tyler Foote Rd. #111
Nevada City, CA 95959-9318
Phone (530) 478-7763

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
I20090205000053 CA Practitioner - Family Practice 7810051919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Sierra Medical Clinic IncGroup PAC ID 3971571217, shared by 4 NPIs, 35 clinicians

Practice addresses (Care Compare)

8676 Marysville Rd
Oregon House, CA 95962-9718
Phone (530) 292-3478

PO Box
Suite 286
Downieville, CA 95936-0286

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43114CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Sierra Medical Clinic, Inc. CurrentSince May 23, 2008 Accepting new patients
Sierra Family Medical Clinic Inc Current Accepting new patients
Western Sierra Medical Clinic, Inc. CurrentSince May 23, 2008 Accepting new patients
Western Sierra Medical Clinic, Inc. Current Accepting new patients
Western Sierra Medical Clinic, Inc. Past Accepting new patients

Locations

1345 Whispering Pines Ln
Grass Valley, CA 95945
Phone (530) 265-7895

15301 Tyler Foote Rd
Nevada City, CA 95959
Phone (530) 292-3478

8676 Marysville Rd
Oregon House, CA 95962
Phone (530) 292-3478

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: peter.vanhouten@wsmc1.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1841411758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14618 TYLER FOOTE RD. #111",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959599318",
            "telephone_number": "530-478-7763",
            "fax_number": "530-292-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 TYLER FOOTE RD.",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959599318",
            "telephone_number": "530-292-3478",
            "fax_number": "530-292-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHOUTEN",
        "first_name": "PETER",
        "middle_name": "DEMEREST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G43114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada City, CA

Sources for this page

Verify at the official NPI Registry.