MICHAEL BLAIR PETERSON M.D.
NPI 1255419024
Surgery in San Leandro, CA
About Michael Blair Peterson M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL BLAIR PETERSON M.D. (NPI 1255419024) is an individual surgery provider in San Leandro, California, licensed in California (G45972) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (1980).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
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
Michael Blair Peterson M.d. 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
3Medicare enrollment records show Michael Peterson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Danville, CA 94526
- Reassigned Medicare billing, California enrollment
- 22 clinicians in this Medicare group
San Ramon, CA 94583
- Reassigned Medicare billing, California enrollment
- 55 clinicians in this Medicare group
Redwood City, CA 94063
- Reassigned Medicare billing, California enrollment
- 20,078 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 10
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 94577 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
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 Michael Peterson's NPI number?
The NPI number for Michael Peterson is 1255419024. It was assigned to this individual provider in the NPPES registry on November 1, 2006.
Where is Michael Peterson located?
Michael Peterson practices at 2500 Merced St, San Leandro, CA 94577. The listed phone number is (510) 454-1000.
What is Michael Peterson's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Michael Peterson enrolled in Medicare?
Yes. Michael 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 Michael Peterson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Michael Peterson reassigns Medicare benefits to 3 organizations: East Bay Cardiovascular And Thoracic Associates Inc. (Danville, CA), Cep America - Auc PC (San Ramon, CA) and Permanente Medical Group Inc (Redwood City, 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 Michael 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 Michael Peterson was last updated on July 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Michael Blair Peterson, M.D. · NPI 1255419024
Surgery physician in San Leandro, California. Individual provider, active in the CMS NPPES registry since November 1, 2006.
## Identity
- **NPI:** 1255419024 (Entity type: Individual)
- **Enumerated:** November 1, 2006
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** G45972 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2500 MERCED ST, San Leandro, CA 94577-4201
- **Phone:** (510) 454-1000
## 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:** 3 organizations under Medicare reassignment (form CMS-855R): East Bay Cardiovascular And Thoracic Associates Inc. (NPI 1073647202, Danville, CA); Cep America - Auc PC (NPI 1750024493, San Ramon, CA); Permanente Medical Group Inc (NPI 1639252604, Redwood City, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, Davis School Of Medicine, class of 1980
## Record status
- **NPPES last updated:** July 14, 2022
- **Other identifiers:** Medicaid 00G459720 (CA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1255419024) · Data from the CMS NPPES public registry.