Bradley S Peterson, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in La Crescenta, California. His current practice location is
2612 El Caminito, La Crescenta, California. You can reach out to his office (for appointments etc.) via phone at
(914) 582-1905.
Bradley S Peterson is licensed to practice in California (license number G130737) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093868663.
Physician's Profile
Full Name | Bradley S Peterson |
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Gender | Male |
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Speciality | Psychiatry & Neurology - Psychiatry |
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Location | 2612 El Caminito, La Crescenta, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1093868663
- Provider Enumeration Date: 01/18/2007
- Last Update Date: 01/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 9436375920
- Enrollment ID: I20140717002526
Medical Identifiers
Medical identifiers for Bradley S Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093868663 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | 221893 (New York) | Secondary |
273R00000X | Psychiatric Unit | 221893 (New York) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | G130737 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Bradley S Peterson allows following entities to bill medicare on his behalf.
Entity Name | Childrens Hospital Los Angeles Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1265530653 PECOS PAC ID: 0143126920 Enrollment ID: O20031211000522 |
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Entity Name | Usc Care Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1902846306 PECOS PAC ID: 0446157747 Enrollment ID: O20050512000412 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bradley S Peterson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Bradley S Peterson, MD 2612 El Caminito, La Crescenta, CA 91214-2963 Ph: (914) 582-1905 | Bradley S Peterson, MD 2612 El Caminito, La Crescenta, CA 91214-2963 Ph: (914) 582-1905 |
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