PETER D MAZONSON (MD) – Internal Medicine Physician, NPI 1811953391

PETER D MAZONSON (MD) is a healthcare provider. based in San jose, California. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. G61502 (CA). The NPI Number for PETER D MAZONSON (MD) is 1811953391

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
PETER D MAZONSON (MD)
NPI
1811953391
Phone
(408) 494-7400
Address
500 TULLY RD
Enumeration Date
25 April 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
GEISEL SCHOOL OF MEDICINE AT DARTMOUTH
Secondary Phone
4088855000
Graduation Year
1982 (44 years ago)
PAC ID
5890988265
Group Practice PAC ID
1254244973
Professional Enrollment ID
I20101018000723
Address ID
CA951282604SA751XXAVEX449
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

21,511 INTERNAL MEDICINE in CA

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Provider Addresses for PETER D MAZONSON (MD)

  • Tully Road, San Jose, Santa Clara County, California, 95122, United States

    VHC TULLY PRIMARY CARE CLINIC

    SAN JOSE, CA 951111917

    Phone: (408) 494-7400

    Type: Location

  • 1036, College Avenue, Menlo Park, San Mateo County, California, 94025, United States

    MENLO PARK, CA 940255210

    Phone: (650) 323-4511

    Type: Mailing

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: 2010-10-18

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
I20101018000723IInternal MedicineCATBD

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 95111)

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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: 1254244973View full group profile
NameSpecialtyState
-CA
Clinical PsychologistCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
-CA
Internal Medicine, Critical Care (Intensivists), Pulmonary DiseaseCA
Nurse PractitionerCA
Internal Medicine, HospitalistPA
-CA
Certified Registered Nurse Anesthetist (Crna)CA

Reviews

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Frequently asked questions

Where can patients find PETER D MAZONSON (MD)'s NPI?
You can confirm PETER D MAZONSON (MD) with NPI 1811953391; it appears in the national provider directory.
Is PETER D MAZONSON (MD) active in the national directory?
PETER D MAZONSON (MD)'s public NPI profile is in an active state.
What field does PETER D MAZONSON (MD) work in?
You can think of PETER D MAZONSON (MD) as practicing within Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for PETER D MAZONSON (MD)?
The page summarizes San Jose, California for PETER D MAZONSON (MD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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