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B D PETERSON MD INC
NPI 1114232204
Family Medicine in Escalon, CA

Active since August 12, 2010
2390 JACKSON AVE, ESCALON, CA 95320(209) 838-6015(209) 838-0750 Get Directions Write a Review

NPPES record last updated: August 12, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About B D Peterson Md Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

B D PETERSON MD INC (NPI 1114232204) is a healthcare organization registered as a family medicine in Escalon, California and active in the NPI registry since August 2010. The organization lists Bob D Peterson, President, as its authorized official.

NPPES Registry Identity

NPI1114232204
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameB D PETERSON MD INC
Location Address2390 JACKSON AVEEscalon, CA 95320-2078
Mailing Address2390 Jackson AveEscalon, CA 95320-2078 · (209) 838-6015 · Fax (209) 838-0750
Phone(209) 838-6015
Fax(209) 838-0750
Organization SubpartNo
Authorized OfficialBob D PetersonPresident · (209) 838-6015
Enumeration DateAugust 12, 2010
✔ NPI 1114232204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · G66903
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2390 JACKSON AVE, Escalon, CA 95320
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Other Identifiers 2

Medicare PIN00G669030CA
Medicare UPINF21959CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

B D Peterson Md Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20100825000084Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to B D Peterson MD Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Bobby Peterson, M.D.
General Practice
NPI 1841359171
2390 JACKSON AVE
Escalon, CA 95320
(209) 838-6015
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is B D Peterson MD Inc's NPI number?

The NPI number for B D Peterson MD Inc is 1114232204. It was assigned to this organization in the NPPES registry on August 12, 2010.

Where is B D Peterson MD Inc located?

B D Peterson MD Inc is located at 2390 Jackson Ave, Escalon, CA 95320. The listed phone number is (209) 838-6015.

What is B D Peterson MD Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is B D Peterson MD Inc enrolled in Medicare?

Yes. B D Peterson MD Inc is registered in the Medicare PECOS enrollment system.

When is B D Peterson MD Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through B D Peterson MD Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to B D Peterson MD Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for B D Peterson MD Inc was last updated on August 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.