JUSTIN ROSS PETERSON M.D.
NPI 1174948012
Internal Medicine in Beale Afb, CA

Q: What is Justin Peterson's NPI number?

The NPI number for Justin Peterson is 1174948012. It was assigned to this individual provider in the NPPES registry on March 1, 2014.

Q: What is Justin Peterson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Peterson was last updated on September 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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 March 01, 2014PECOS Enrolled

15301 WARREN SHINGLE RD, ATTN: KEN WINN, CREDENTIAL COORDINATOR, BEALE AFB, CA 95903(530) 634-4662 Get Directions Write a Review

NPPES record last updated: September 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 4, 2025, Jul 2, 2024, Jun 6, 2023 and 4 more (7 updates tracked since 2017).

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About Justin Ross Peterson M.d. NPPES

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

JUSTIN ROSS PETERSON M.D. (NPI 1174948012) is an individual internal medicine provider in Beale Afb, California, licensed in California (154828) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS and maintains a secondary practice location in Travis Afb.

NPPES Registry Identity

NPI1174948012

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJUSTIN ROSS PETERSONCredential: M.D.

Location Address15301 WARREN SHINGLE RD, ATTN: KEN WINN, CREDENTIAL COORDINATORBeale Afb, CA 95903

Mailing Address15301 Warren Shingle RdBeale Afb, CA 95903-1905 · (530) 634-4662 · Fax (530) 634-4763

Phone(530) 634-4662

Sole ProprietorNo

Enumeration DateMarch 1, 2014

Last NPPES UpdateSeptember 4, 20257 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2025

✔ NPI 1174948012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in CA · 154828✔ Licensed in VA · 0101259916

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

15301 WARREN SHINGLE RD, Beale Afb, CA 95903

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Secondary Practice Location 1

Location 1101 Bodin CirTravis AFB, CA 94535-1809 · Phone (707) 423-7611

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Ross Peterson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95903 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

$133.94 typical visit price

range $58.87 – $176.60

Typical copayment $33.48 (range $14.71 – $44.15)

Most-billed visit code 99204

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

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

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers12 claims12 services$215.65 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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. TIMOTHY LON HALPIN D.O.

Family Medicine

15301 WARREN SHINGLE RD, 9TH MEDICAL GROUP CLINIC
BEALE AFB, CA 95903

Yuba County (530) 634-4699

DR. NATHANIEL DEAN FORD MD, MPH

Internal Medicine