NPIMap

Individual provider Active NPI

Daniel L Peterson, MD

  • Internal Medicine Physician
  • Incline Village, NV
National Provider Identifier
1972630564
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4249 Issued in NV
Practice address
926 Incline Way
Unit 150
Incline Village, NV 89451-7933
Phone
(775) 832-0989
Fax
(775) 832-3046
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4249 NV Primary

Addresses

Primary practice location

926 Incline Way
Unit 150
Incline Village, NV 89451-7933

Mailing address

PO Box 11249
Reno, NV 89510-1249
Phone (775) 832-0989

Other identifiers 1

IdentifierTypeStateIssuer
002016984MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000279 NV Practitioner - Internal Medicine 9638194640 Practice locations: Incline Village, NV

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Rochester School of Medicine and Dentistry, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

926 Incline Way
Unit 250
Incline Village, NV 89451-8425
Phone (775) 832-4886

Hospital & facility affiliations

  • Incline Village Community Hospital Hospital, Incline Village, NV, CCN 291301
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
  • Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328
  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

Merit-based Incentive Payment System (MIPS)

Final score
75.06 of 100Reported as group
Quality
83.97
Promoting interoperability
88
Improvement activities
40
Cost
42.89

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Grant General Hospital Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients

Organizations & group practices 3

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 6

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1972630564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11249",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895101249",
            "telephone_number": "775-832-0989",
            "fax_number": "775-832-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 INCLINE WAY",
            "address_2": "UNIT 150",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "894517933",
            "telephone_number": "775-832-0989",
            "fax_number": "775-832-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "4249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016984",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Incline Village, NV

Sources for this page

Verify at the official NPI Registry.