PENINSULA PLASTIC SURGERY MEDICAL GROUP INC
NPI 1902666324
Plastic Surgery in Burlingame, CA

Q: What is Peninsula Plastic Surgery Medical Group Inc's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Active since March 21, 2024

1750 EL CAMINO REAL STE 405, BURLINGAME, CA 94010(650) 692-0467 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Peninsula Plastic Surgery Medical Group Inc NPPES

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

PENINSULA PLASTIC SURGERY MEDICAL GROUP INC (NPI 1902666324) is a healthcare organization registered as a plastic surgery in Burlingame, California and active in the NPI registry since March 2024. The organization lists Michelle Butler, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1902666324

Entity TypeOrganization

Primary Taxonomy208200000X

Legal Business NamePENINSULA PLASTIC SURGERY MEDICAL GROUP INC

Location Address1750 EL CAMINO REAL STE 405Burlingame, CA 94010-3217

Mailing Address1750 El Camino Real Ste 405Burlingame, CA 94010-3217 · (650) 692-0467

Phone(650) 692-0467

Organization SubpartNo

Authorized OfficialMichelle ButlerAuthorized Official · (415) 713-4341

Enumeration DateMarch 21, 2024

NPPES CertifiedMarch 21, 2024

✔ NPI 1902666324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

1750 EL CAMINO REAL STE 405, Burlingame, CA 94010

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peninsula Plastic Surgery Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Peninsula Plastic Surgery Medical Group Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ari Wes

Plastic and Reconstructive Surgery

NPI 1265929772

1750 EL CAMINO REAL STE 405
Burlingame, CA 94010

(650) 692-0467

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Peninsula Plastic Surgery Medical Group Inc's NPI number?

The NPI number for Peninsula Plastic Surgery Medical Group Inc is 1902666324. It was assigned to this organization in the NPPES registry on March 21, 2024.

Where is Peninsula Plastic Surgery Medical Group Inc located?

Peninsula Plastic Surgery Medical Group Inc is located at 1750 El Camino Real Ste 405, Burlingame, CA 94010. The listed phone number is (650) 692-0467.

What is Peninsula Plastic Surgery Medical Group Inc's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Peninsula Plastic Surgery Medical Group Inc enrolled in Medicare?

Yes. Peninsula Plastic Surgery Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Peninsula Plastic Surgery Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Peninsula Plastic Surgery Medical Group Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Peninsula Plastic Surgery Medical Group Inc was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.