Kenneth A Peterson (NPI# 1871565788, PAC ID# 6204736283) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1871565788 |
| PAC ID by PECOS | 6204736283 |
| Professional Enrollment ID | I20040113000703 |
| Full Name | Kenneth A Peterson |
| Address |
911 Oak Park Blvd Suite 104 Pismo Beach CA 93449-3406 |
| Gender | M |
| Credential | OD |
| Graduation Year | 1998 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 911 Oak Park Blvd, Suite 104, Pismo Beach, CA 93449-3406 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 91% | |
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 91% | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 97% | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 97% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 87% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 87% |
| Street Address |
911 OAK PARK BLVD SUITE 104 |
| City | PISMO BEACH |
| State | CA |
| Zip | 93449-3406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven J Clark | Podiatry | Steve Clark, Dpm, Inc. | 911 Oak Park Blvd, Suite 106, Pismo Beach, CA 93449-3406 |
| Thomas P Knecht | Endocrinology | Michael K. Lai, M.d., Inc | 911 Oak Park Blvd, Suite 105, Pismo Beach, CA 93449-3406 |
| James R Skow | Thoracic Surgery | Central Coast Cardiothoracic Surgical Associates-a Medical Group | 911 Oak Park Blvd, Suite 102, Pismo Beach, CA 93449-3406 |
| Brian O Carroll | Podiatry | 911 Oak Park Blvd, Suite 106, Pismo Beach, CA 93449-3406 | |
| Stephen J Freyaldenhoven | Thoracic Surgery | Central Coast Cardiothoracic Surgical Associates-a Medical Group | 911 Oak Park Blvd, Suite 102, Pismo Beach, CA 93449-3406 |
| Michael K Lai | Endocrinology | Michael K. Lai, M.d., Inc | 911 Oak Park Blvd, Suite 105, Pismo Beach, CA 93449-3406 |
| Paul A Perry | Cardiac Surgery | Central Coast Cardiothoracic Surgical Associates-a Medical Group | 911 Oak Park Blvd, Suite 102, Pismo Beach, CA 93449-3406 |
| Luke A Faber | Thoracic Surgery | Central Coast Cardiothoracic Surgical Associates-a Medical Group | 911 Oak Park Blvd, Suite 102, Pismo Beach, CA 93449-3406 |
| David A Canvasser | Thoracic Surgery | Central Coast Cardiothoracic Surgical Associates-a Medical Group | 911 Oak Park Blvd, Suite 102, Pismo Beach, CA 93449-3406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Evans | Gastroenterology | Santa Maria Gastroenterology Medical Group Inc. | 931 Oat Park Blvd, Suite 101, Pismo Beach, CA 93449 |
| Igor J Nastaskin | Gastroenterology | Santa Maria Gastroenterology Medical Group Inc. | 931 Oat Park Blvd, Suite 101, Pismo Beach, CA 93449 |
| Max M Maude | Physician Assistant | Timothy H Jones Md Inc | 302 Vista Del Mar Ave, Shell Beach, CA 93449-1833 |
| Andrew Peterson | Chiropractic | 1251 Shell Beach Rd, Pismo Beach, CA 93449-1953 | |
| Wendy E Weiss | Family Medicine | 575 Price St, Suite 101, Pismo Beach, CA 93449-2553 | |
| Johnnie A Ham | Obstetrics/gynecology | 575 Price St, Suite 313, Pismo Beach, CA 93449-2553 | |
| Sarah A Cole | Nurse Practitioner | Coastal Prestige Medical Services, Inc | 575 Price St, Suite 313, Pismo Beach, CA 93449-2553 |
| Rand C Ritchie | Psychiatry | 354 Main St, Suite C, Pismo Beach, CA 93449-2581 | |
| Denise M Dritsas | Psychologist, Clinical | 310 James Way, Suite 150, Pismo Beach, CA 93449-2877 | |
| Ann Marie Donnelly | Psychologist, Clinical | 310 James Way, Suite 110, Pismo Beach, CA 93449-2877 | |
| Find all physicians in zip 93449 | |||
| City | PISMO BEACH |
| Zip Code | 93449 |
| Specialty | OPTOMETRY |
| City + Specialty | PISMO BEACH + OPTOMETRY |
Please comment or provide details below to improve the information on Kenneth A Peterson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.