NATHAN RANDALL PETERSON D.O. NPI 1053459867

NPI Information

  • NPI: 1053459867
  • Provider Name: NATHAN RANDALL PETERSON, D.O.
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: SANTA MARGARITA
    CAMP PENLETON, CA
    ZIP 92055
  • Phone: (760) 725-1288

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NPI Details

Nathan Randall Peterson, D.O. is a student in an organized health care education training program in Camp Penleton, CA with 20 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Nathan Randall Peterson, D.O. NPI is 1053459867. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

SANTA MARGARITA
CAMP PENLETON, CA
ZIP 92055
Phone: (760) 725-1288

The NPI 1053459867 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection, triamcinolone acetonide, preservative free, 1 mg (HCPCS:J3300)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Destruction of skin growth, 1-14 growths (HCPCS:17110)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Superficial and/or low voltage radiation treatment delivery (HCPCS:77401)
  • Simple or single drainage of skin abscess (HCPCS:10060)
  • Biopsy of related skin growth, first growth (HCPCS:11102)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks (HCPCS:17311)
  • Radiation treatment management, 5 treatment sessions (HCPCS:77427)
  • Destruction of birthmark, more than 50.0 sq cm (HCPCS:17108)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Destruction of precancer skin growth, 15 or more growths (HCPCS:17004)
  • Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg (HCPCS:J0702)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Calculation of radiation therapy dose (HCPCS:77300)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks (HCPCS:17312)
  • Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS:13121)
  • Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved (HCPCS:77290)
  • Destruction of skin growth, 15 or more growths (HCPCS:17111)
  • Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) (HCPCS:J7308)
  • Biopsy of related skin growth, each additional growth (HCPCS:11103)
  • Application of light to destroy precancer skin growth (HCPCS:96567)
  • Complicated repair of wound of trunk, 2.6-7.5 cm (HCPCS:13101)
  • Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
  • Biopsy of ear (HCPCS:69100)
  • Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm (HCPCS:17262)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Injection into skin growth, 1-7 growths (HCPCS:11900)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm (HCPCS:13152)
  • Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11402)
  • Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less (HCPCS:13122)
  • Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 2/2/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training Program39020000XARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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