MIGUEL A SR. PERALTA (PA-C) – Surgical Physician Assistant, NPI 1619196474

MIGUEL A SR. PERALTA (PA-C) is a healthcare provider. based in Burbank, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 19101 (CA). The NPI Number for MIGUEL A SR. PERALTA (PA-C) is 1619196474

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
MIGUEL A SR. PERALTA (PA-C)
NPI
1619196474
Phone
(818) 841-3936
Address
2625 W ALAMEDA AVE
Enumeration Date
24 April 2007
Last Update Date
6 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5624613000
Graduation Year
2006 (20 years ago)
PAC ID
0042317570
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20070517000669
Address ID
CA902422814DO9449XHWYX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

10,570 PHYSICIAN ASSISTANT in CA

Provider Addresses for MIGUEL A SR. PERALTA (PA-C)

  • 2625 W ALAMEDA AVE

    #116

    BURBANK, CA 915054806

    Phone: (818) 841-3936

    Fax: (818) 841-5974

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070517000669IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91505)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

What unique ID ties claims to MIGUEL A SR. PERALTA (PA-C)?
NPI 1619196474 is assigned to MIGUEL A SR. PERALTA (PA-C) under the national enumeration system.
Is MIGUEL A SR. PERALTA (PA-C)'s NPI currently valid?
The extract we use shows MIGUEL A SR. PERALTA (PA-C) as active.
What field does MIGUEL A SR. PERALTA (PA-C) work in?
You can think of MIGUEL A SR. PERALTA (PA-C) as practicing within Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Does MIGUEL A SR. PERALTA (PA-C) practice in California?
You will see Burbank, California on file for MIGUEL A SR. PERALTA (PA-C) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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