DR. TYLER ANDREW PETERSON DO
NPI 1124643960
Family Medicine in West Covina, CA
About Dr. Tyler Andrew Peterson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TYLER ANDREW PETERSON DO (NPI 1124643960) is an individual family medicine provider in West Covina, California, licensed in California (20A19747) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and is a graduate of Touro Un College Of Osteopathic Medicine, Vallejo (2018).
NPPES Registry Identity
Specialties & Licenses
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
Dr. Tyler Andrew Peterson Do 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.
Medicare Billing Reassignments
4Medicare enrollment records show Tyler Peterson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Baldwin Park, CA 91706
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Orange, CA 92868
- Reassigned Medicare billing, California enrollment
- 250 clinicians in this Medicare group
Orange, CA 92868
- Reassigned Medicare billing, California enrollment
- 187 clinicians in this Medicare group
Fountain Valley, CA 92708
- Reassigned Medicare billing, California enrollment
- 948 clinicians in this Medicare group
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 7
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91790 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
WEST COVINA, CA 91790
WEST COVINA, CA 91790
WEST COVINA, CA 91790
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 Tyler Peterson's NPI number?
The NPI number for Tyler Peterson is 1124643960. It was assigned to this individual provider in the NPPES registry on June 8, 2020.
Where is Tyler Peterson located?
Tyler Peterson practices at 1115 S Sunset Ave, West Covina, CA 91790. The listed phone number is (626) 962-4011.
What is Tyler Peterson's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Tyler Peterson enrolled in Medicare?
Yes. Tyler Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Tyler Peterson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Peterson reassigns Medicare benefits to 4 organizations: Southern California Permanente Medical Group (Baldwin Park, CA), The Regents Of The University Of California-Irvine (Orange, CA), Southern California Hospitalist Network Medical Group Inc (Orange, CA) and Memorialcare Medical Foundation (Fountain Valley, CA). Each 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 Tyler Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Tyler Peterson was last updated on March 5, 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.
# Dr. Tyler Andrew Peterson, DO · NPI 1124643960
Family Medicine physician in West Covina, California. Individual provider, active in the CMS NPPES registry since June 8, 2020.
## Identity
- **NPI:** 1124643960 (Entity type: Individual)
- **Enumerated:** June 8, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 20A19747 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1115 S SUNSET AVE, West Covina, CA 91790-3940
- **Phone:** (626) 962-4011
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Southern California Permanente Medical Group (NPI 1770515280, Baldwin Park, CA); The Regents Of The University Of California-Irvine (NPI 1154479723, Orange, CA); Southern California Hospitalist Network Medical Group Inc (NPI 1790880458, Orange, CA); Memorialcare Medical Foundation (NPI 1205167350, Fountain Valley, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Touro Un College Of Osteopathic Medicine, Vallejo, class of 2018
## Record status
- **NPPES last updated:** March 5, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1124643960) · Data from the CMS NPPES public registry.