Individual provider Active NPI

Peter John Eichwald, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Redding, CA
National Provider Identifier
1992257778
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005008 Issued in CA
Practice address
2107 Airpark Dr
Redding, CA 96001-2433
Phone
(530) 241-1111
Fax
(530) 241-4870
NPI assigned
Oct 27, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005008 CA Primary

Addresses

Primary practice location

2107 Airpark Dr
Redding, CA 96001-2433

Mailing address

2107 Airpark Dr
Redding, CA 96001-2433
Phone (530) 241-1111

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221001824 CA Practitioner - Nurse Practitioner 9133403066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2107 Airpark Dr
Redding, CA 96001-2433
Phone (530) 241-1111

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as group
Quality
96.26
Improvement activities
40
Cost
72.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005008CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Redding Dermatology Medical Group, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Redding Dermatology Medical Group, Inc. CurrentSince Apr 1, 2019 Accepting new patients

Locations

2107 Airpark Dr
Redding, CA 96001
Phone (530) 241-1111

Interoperability endpoints

  • Direct secure messaging: peichwald@directaddress.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1992257778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-241-1111",
            "fax_number": "530-241-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-241-1111",
            "fax_number": "530-241-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHWALD",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-27",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.