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PETER PAUL PENG PA-C
NPI 1497421747
Physician Assistant - Surgical in Loma Linda, CA

Active since August 17, 2021PECOS EnrolledAccepts Medicare Assignment
85.18/100
CMS Quality Rating
11175 CAMPUS ST STE 21121, LOMA LINDA, CA 92350(909) 558-5959 Get Directions Write a Review

NPPES record last updated: July 11, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 11, 2023, Oct 18, 2021, Aug 17, 2021 (3 updates tracked since 2021).

About Peter Paul Peng Pa-c NPPES

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

PETER PAUL PENG PA-C (NPI 1497421747) is an individual surgical provider in Loma Linda, California, licensed in California (PA60228) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1497421747
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NamePETER PAUL PENGCredential: PA-C
Location Address11175 CAMPUS ST STE 21121Loma Linda, CA 92350-1700
Mailing Address33814 Cansler WayYucaipa, CA 92399-6987 · (914) 980-5001
Phone(909) 558-5959
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 17, 2021
Last NPPES UpdateJuly 11, 20233 updates tracked since enumeration
NPPES CertifiedJuly 11, 2023
✔ NPI 1497421747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CA · PA60228
11175 CAMPUS ST STE 21121, Loma Linda, CA 92350
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Peter Paul Peng Pa-c 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 ID7810388444
PECOS Enrollment IDI20211215001691
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.

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.

Coronary artery bypass using artery graft, 1 graft 33533
A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.
12 services12 patients
Extensive reconstruction of upper heart chamber and alteration of electrical pathway using an endoscope 33266
This procedure involves significant reshaping of the upper chamber of your heart using a small camera (endoscope). It also changes the heart's electrical pathway to improve its function. It's a minimally invasive operation aimed at restoring normal heart rhythm.
11 services11 patients
Harvest of vein using an endoscope 33508
Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.
11 services11 patients

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.

85.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.81
Promoting Interoperability82
Improvement Activities40
Cost64.54

Other Providers at the Same Location NPPES

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

MONA KAKAVAND
Student in an Organized Health Care Education/Training Program
11175 CAMPUS ST STE 21121
LOMA LINDA, CA 92350
San Bernardino County (909) 558-5595

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 Peter Peng's NPI number?

The NPI number for Peter Peng is 1497421747. It was assigned to this individual provider in the NPPES registry on August 17, 2021.

Where is Peter Peng located?

Peter Peng practices at 11175 Campus St Ste 21121, Loma Linda, CA 92350. The listed phone number is (909) 558-5959.

What is Peter Peng's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Peter Peng enrolled in Medicare?

Yes. Peter Peng 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.

When was this NPI record last updated?

The NPPES record for Peter Peng was last updated on July 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.