NPIMap

Individual provider Active NPI

Mary C Gessner-Peterson, DO

  • Emergency Medical Services (Emergency Medicine) Physician
  • Alpine, CA
National Provider Identifier
1861662884
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
OS014103 Issued in PA
Practice address
2710 Alpine Blvd # 205
Alpine, CA 91901-2276
Phone
(619) 326-4445
NPI assigned
Mar 5, 2008
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A1174 CA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X OS014103 PA Primary

Addresses

Primary practice location

2710 Alpine Blvd # 205
Alpine, CA 91901-2276

Mailing address

2710 Alpine Blvd
Alpine, CA 91901-2276
Phone (619) 326-4445

Other practice location 1

1730 Alpine Blvd Ste 109B
Alpine, CA 91901-3877
Phone (619) 326-4445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110607000169 CA Practitioner - Internal MedicinePractitioner - Emergency Medicine 9638200033 Reassigns benefits to 4 organizations
I20200103002441 UT Practitioner - Internal Medicine 9638200033

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Gessner-Peterson Medical Group IncGroup PAC ID 1658526637, 4 clinicians

Practice addresses (Care Compare)

1832 Alpine Blvd
Suite B
Alpine, CA 91901-2107
Phone (978) 994-1766

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.89 of 100Reported as individual
Quality
55.99
Promoting interoperability
88
Improvement activities
40
Cost
33.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A1174CAMDInternal Medicine Physician
11744CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alvarado Emergency Medical Associates, Inc. CurrentSince Jun 1, 2011 Accepting new patients
Mary Gessner-Peterson Medical Group, Inc Internal Medicine CurrentSince Oct 2, 2012 Accepting new patients
Team Physicians of Northern California Medical Group Inc CurrentSince Aug 19, 2016 Accepting new patients
Gessner Peterson House Calls Inc Emergency Medical Services CurrentSince Oct 13, 2019 Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Locations

1730 Alpine Blvd
Ste 109B
Alpine, CA 91901
Phone (619) 326-4445

1730 Alpine Blvd
Ste 205
Alpine, CA 91901
Phone (619) 326-4445

1832 Alpine Blvd
Ste B
Alpine, CA 91901
Phone (619) 326-4445

2710 Alpine Blvd
#434
Alpine, CA 91901

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

41 E 400 N
Logan, UT 84321
Phone (435) 640-6290

2938 S Redwood Rd
West Valley City, UT 84119
Phone (801) 978-2424

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12903/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.gessner-peterson.1@12903.direct.athenahealth.com
  • Direct secure messaging: mary.gessner.1@12903.direct.athenahealth.com
  • Direct secure messaging: mary.gessner.2@12903.direct.athenahealth.com
  • Direct secure messaging: mgessner33831@sharphealthcare.direct-ci.com

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1861662884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 ALPINE BLVD",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919012276",
            "telephone_number": "619-326-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 ALPINE BLVD # 205",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919012276",
            "telephone_number": "619-326-4445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 Alpine Blvd Ste 109B",
            "address_purpose": "LOCATION",
            "city": "Alpine",
            "state": "CA",
            "postal_code": "919013877",
            "country_code": "US",
            "telephone_number": "619-326-4445",
            "fax_number": "619-722-1721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GESSNER-PETERSON",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A1174",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "PA",
            "license": "OS014103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, CA

Sources for this page

Verify at the official NPI Registry.