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MR. PETER LAWRENCE BIRNBAUM MD
NPI 1740269752
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Fresno, CA

Active since January 10, 2006PECOS EnrolledAccepts Medicare Assignment
72.73/100
CMS Quality Rating
1377 E HERNDON AVE, SUITE 104, FRESNO, CA 93720(559) 450-7455(559) 450-7473 Get Directions Write a Review

NPPES record last updated: July 3, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Peter Lawrence Birnbaum Md NPPES

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

MR. PETER LAWRENCE BIRNBAUM MD (NPI 1740269752) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Fresno, California, licensed in California (A52432) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1984).

NPPES Registry Identity

NPI1740269752
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameMR. PETER LAWRENCE BIRNBAUMCredential: MD
Location Address1377 E HERNDON AVE, SUITE 104Fresno, CA 93720-3022
Mailing Address1377 E Herndon Ave, Suite 104Fresno, CA 93720-3022 · (559) 450-7455 · Fax (559) 450-7473
Phone(559) 450-7455
Fax(559) 450-7473
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateJanuary 10, 2006
Last NPPES UpdateJuly 3, 2013
✔ NPI 1740269752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in CA · A52432
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
1377 E HERNDON AVE, Fresno, CA 93720
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Other Identifiers 3

OtherBO411XCA · Ptan
Medicare PIN00A524320CA
Medicare UPINF75912

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

Mr. Peter Lawrence Birnbaum 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 ID648327270
PECOS Enrollment IDI20090416000336
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 9

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.

Replacement of aortic valve through the skin and femoral artery 33361
This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.
41 services41 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
33 services33 patients
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.
29 services29 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.
24 services24 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
20 services20 patients
Exclusion of appendage of left upper chamber of heart performed during other procedure on chest 33268
This is a procedure done on the heart's left upper chamber (atrium). The small pouch-like appendage is sealed off during another chest procedure. This is done to reduce the risk of blood clots forming and causing strokes.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93720 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
$176.60 typical visit price
range $58.87 – $176.60
Typical copayment $44.15 (range $14.71 – $44.15)
Most-billed visit code 99205
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

72.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.14
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
13%84 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
6%35 patients1/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%26 patients5/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
95%60 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
28%80 patients2/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
12%42 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
52%52 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
40%80 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
3%80 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
5%80 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

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

MRS. DENISE AGUILAR RN PA NP
Physician Assistant
1377 E HERNDON AVE, SUITE 104
FRESNO, CA 93720
Fresno County (559) 450-7455
GREATER FRESNO DEVELOPMENT CORP.
Pharmacy (Community/Retail Pharmacy)
1377 E HERNDON AVE
FRESNO, CA 93720
Fresno County (559) 435-1950
WALTER SAMUEL HURTADO PA C
Physician Assistant (Surgical)
1377 E HERNDON AVE, SUITE 104
FRESNO, CA 93720
Fresno County (559) 450-7455
JOE RANDOLPH BOLTON MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1377 E HERNDON AVE, #104
FRESNO, CA 93720
Fresno County (559) 450-7455
SAINT AGNES MEDICAL PROVIDERS INC
Emergency Medicine
1377 E HERNDON AVE, SUITE 104
FRESNO, CA 93720
Fresno County (559) 450-7455

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 Birnbaum's NPI number?

The NPI number for Peter Birnbaum is 1740269752. It was assigned to this individual provider in the NPPES registry on January 10, 2006.

Where is Peter Birnbaum located?

Peter Birnbaum practices at 1377 E Herndon Ave Suite 104, Fresno, CA 93720. The listed phone number is (559) 450-7455.

What is Peter Birnbaum's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Peter Birnbaum enrolled in Medicare?

Yes. Peter Birnbaum 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 Birnbaum was last updated on July 3, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.