Melissa R Peterson, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

AP4400 Issued in AZ

Practice address

1760 E Pecos Rd
Suite 516
Gilbert, AZ 85295-3200

Phone

(480) 814-1910

Fax

(480) 857-2667

NPI assigned

Feb 17, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Momdoc, LLC

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
  • NPI 1184780355
  Medicare reassignment Care Compare group
• Healthy Pregnancy Perinatology, LLC

  • Maternal & Fetal Medicine Physician
  • Gilbert, AZ
  • NPI 1467725812
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1013280296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E PECOS RD",
            "address_2": "SUITE 516",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953200",
            "telephone_number": "480-814-1910",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MELISSA",
        "middle_name": "R",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "AP4400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "697276",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Amy Petersen, LM
• Brad Michael Peterson, CRNA
• Donna Lee Peterson, M.SC. SLP
• Jonathan J Peterson, DC
• Leila King Peterson, M.D.
• Monika Sandberg Peterson, PH.D.
• Ryan Peterson, PT
• Taylor Paige Peterson, COTA
• Shay Petillo
• Colleen Marie Petras, PT

• Advanced Practice Midwife in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Advanced Practice Midwife in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.