David James Petersen, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4310 Issued in CA

Practice address

24191 Paseo de Valencia
Suite E
Laguna Woods, CA 92637-3167

Phone

(949) 855-1177

Fax

(949) 855-6939

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Foot and Ankle Center a Podiatry CorporationGroup PAC ID 7517979297, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pacific Foot & Ankle Center a Podiatry Corporation

  • Foot & Ankle Surgery Podiatrist
  • Laguna Woods, CA
  • NPI 1780623173
  Medicare reassignment Care Compare group NPD Authorized official
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1942250808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24191 PASEO DE VALENCIA",
            "address_2": "SUITE E",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373167",
            "telephone_number": "949-855-1177",
            "fax_number": "949-855-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24191 PASEO DE VALENCIA",
            "address_2": "SUITE E",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373167",
            "telephone_number": "949-855-1177",
            "fax_number": "949-855-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDI-CARE PIN",
            "identifier": "DE7237",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Foot & Ankle Center a Podiatry Corporation
• Palm Terrace
• Jo Ann Panitch, M.F.T.
• Sabrina Park
• Amar Arun Patel, MD
• Nicola Polic, PT, DPT
• Naghmeh Ramezani
• Susan E Ramsey, MFC, LMFT
• Natalie Elaine Reed, PA-C
• Kathleen Reeder

• Foot & Ankle Surgery Podiatrist in Laguna Woods, CA
• Providers in Laguna Woods, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.