JONATHAN MICHAEL PETERSON MD
NPI 1124641071
Ophthalmology in San Diego, CA

Q: What is Jonathan Peterson's NPI number?

The NPI number for Jonathan Peterson is 1124641071. It was assigned to this individual provider in the NPPES registry on May 27, 2020.

Q: What is Jonathan Peterson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Peterson was last updated on July 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since May 27, 2020PECOS EnrolledAccepts Medicare Assignment

200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: July 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 1, 2024, Dec 11, 2023, May 27, 2020 (3 updates tracked since 2020).

On this page

About Jonathan Michael Peterson Md NPPES

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

JONATHAN MICHAEL PETERSON MD (NPI 1124641071) is an individual ophthalmology provider in San Diego, California, licensed in California (A196755) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1124641071

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameJONATHAN MICHAEL PETERSONCredential: MD

Location Address200 W ARBOR DRSan Diego, CA 92103-9000

Mailing AddressFile 57326Los Angeles, CA 90074-0001

Phone(800) 926-8273

Fax(888) 539-8781

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMay 27, 2020

Last NPPES UpdateJuly 1, 20243 updates tracked since enumeration

NPPES CertifiedJuly 1, 2024

✔ NPI 1124641071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in CA · A196755

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

200 W ARBOR DR, San Diego, CA 92103

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Secondary Practice Locations 3

Location 1200 Lothrop StPittsburgh, PA 15213-2536 · Phone (412) 647-2345

Location 29415 Campus Point DrLA Jolla, CA 92093-2536 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 39300 Campus Point DrLA Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jonathan Michael Peterson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173949252

PECOS Enrollment IDI20250917001808

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Jonathan Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Regents Of The University Of California

0.1 mi

Ophthalmology

200 W ARBOR DR
San Diego, CA 92103

Reassigned Medicare billing, California enrollment
129 clinicians in this Medicare group

NPI 1699877621 (800) 926-8273

Meadows Healthcare LLC

252 mi

Retina Specialist

2749 SUNRIDGE HEIGHTS PKWY
Henderson, NV 89052

Reassigned Medicare billing, Nevada enrollment
23 clinicians in this Medicare group

NPI 1881083921 (702) 358-0472

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

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

165 services150 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

26 services26 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

22 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAMIN MOTARJEMI M.D.

Internal Medicine (Geriatric Medicine)