Peninsula Plastic Surgery Medical Group Inc

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

PENINSULA PLASTIC SURGERY MEDICAL GROUP INC

Practice address

1750 El Camino Real Ste 405
Burlingame, CA 94010-3217

Phone

(650) 692-0467

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Butler

Title

Authorized Official

Phone

(415) 713-4341

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ari Wes

  • Plastic Surgery Physician
  • Burlingame, CA
  • NPI 1265929772
  Medicare reassignment NPD
• Lorne K Rosenfield, MD

  • Plastic Surgery Physician
  • Burlingame, CA
  • NPI 1295712792
  NPD (past)

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1902666324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL STE 405",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103217",
            "telephone_number": "650-692-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL STE 405",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103217",
            "telephone_number": "650-692-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PLASTIC SURGERY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "415-713-4341"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Medical Group
• Peninsula Neurological Associates
• Peninsula Ophthalmology Group, Inc.
• Peninsula Pathologists Medical Group Inc.
• Peninsula Pediatric Med GRP Inc
• Peninsula Professional Center Pharmacy
• Peninsula Sleep Center Inc
• Peninsula Surgical Specialist Medical Group, Inc (Surgical Associates of the Peninsula)
• Peninsula Surgical Specialist Medical Group, Inc. (Surgical Associates of the Peninsula A Medical Group, Inc.)
• Peninsula Wellness Psychological Corporation (Peninsula Wellness)

• Plastic Surgery Physician in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.