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DR. SCOTT J. PETERSEN MD
NPI 1710034251
General Practice in Oakland, CA

Active since January 05, 2007PECOS EnrolledAccepts Medicare Assignment
275 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-1000(510) 620-9222 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Scott J. Petersen Md NPPES

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

DR. SCOTT J. PETERSEN MD (NPI 1710034251) is an individual general practice provider in Oakland, California, licensed in California (G066975) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Boston University School Of Medicine (1988).

NPPES Registry Identity

NPI1710034251
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. SCOTT J. PETERSENCredential: MD
Location Address275 W MACARTHUR BLVDOakland, CA 94611-5641
Mailing Address275 W Macarthur BlvdOakland, CA 94611-5641 · (510) 752-1000 · Fax (510) 620-9222
Phone(510) 752-1000
Fax(510) 620-9222
Sole ProprietorNo
Medical School CMSBoston University School Of MedicineGraduated 1988
Enumeration DateJanuary 5, 2007
Last NPPES UpdateDecember 15, 2021
✔ NPI 1710034251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · G066975
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
275 W MACARTHUR BLVD, Oakland, CA 94611
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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

Dr. Scott J. Petersen 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 ID7810180510
PECOS Enrollment IDI20101026000240
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.

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. ANNA C. MORGAN MD
Specialist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. TRANG H. LA MD
Radiology (Radiation Oncology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. AMIN MATIN M.D., M.P.H.
Radiology (Diagnostic Radiology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (925) 295-5758
SUCHETA KORWAR MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
MR. MATTHEW GABRIELSON D.P.T.
Physical Therapist (Orthopedic)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6221
MALORIE HACKER MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
RENEE L. PERRY DO
Obstetrics & Gynecology
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
HERPRIT KAUR MAHAL MD
Hospitalist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000

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 Scott Petersen's NPI number?

The NPI number for Scott Petersen is 1710034251. It was assigned to this individual provider in the NPPES registry on January 5, 2007.

Where is Scott Petersen located?

Scott Petersen practices at 275 W Macarthur Blvd, Oakland, CA 94611. The listed phone number is (510) 752-1000.

What is Scott Petersen's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Scott Petersen enrolled in Medicare?

Yes. Scott Petersen 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 Scott Petersen was last updated on December 15, 2021. 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.