Alec Petersen

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME145182 Issued in FL

Practice address

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Phone

(615) 275-6612

NPI assigned

Apr 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, TN, TX, FL, NC, IL, AL, KY8 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 8

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Devoted Medical Group Professional Corporation

  • Primary Care Clinic/Center
  • Pembroke Pines, FL
  • NPI 1245838168

  KY, TN

  Medicare reassignment NPD
• Devoted Medical Group of Texas Inc

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1982202800
  Medicare reassignment NPD
• Devoted Medical NC PC

  • Primary Care Clinic/Center
  • Zirconia, NC
  • NPI 1295443554
  Medicare reassignment NPD
• Devoted Medical PA PC

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1114642683
  Medicare reassignment NPD
• Devoted Medical PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1467125203
  Medicare reassignment NPD
• Devoted Medical Group Inc

  • Primary Care Clinic/Center
  • Beachwood, OH
  • NPI 1609474527

  AL

  Medicare reassignment
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1013370568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 SW 149TH AVE STE 100",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274166",
            "telephone_number": "617-732-6660",
            "fax_number": "617-975-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "615-275-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ALEC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2024-01-19",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "67960",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.144623",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "45918",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036167875",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-02940",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T5434",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME145182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Paul Pescatore, PT
• Alex Peskoe
• Ileana Pestana
• Patricia Lynn Peters, D.O.
• Robert A Peters, DC
• Lina Maria Peterson, PT
• Ryan Petit, DO
• Emanuela Petrila, PT
• Nicola Petrovani, M.D.
• Natasha Marie Petrovich, DPT

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.