Active NPI
Todd Victor Peterson, MD
- Family Medicine Physician
- Chambersburg, PA
National Provider Identifier
1023012408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD065733L
- Practice address
- 3208 Baltusrol Dr
Chambersburg, PA 17202-7038 - Phone
- (717) 860-0890
- NPI assigned
- Jun 13, 2005
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD065733L | PA | Primary |
Addresses
Primary practice location
3208 Baltusrol Dr
Chambersburg, PA 17202-7038
Mailing address
3208 Baltusrol Dr
Chambersburg, PA 17202-7038
Phone (717) 860-0890
Other identifiers 24
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25-1716306 | Other | PA | HEALTHNET/TRICARE |
| 50059950 | Other | PA | CAPITAL BLUECROSS (EPIQ) |
| 50085311 | Other | PA | CAPITAL BLUECROSS (WH) |
| 080135921 | Other | PA | RAILROAD MEDICARE |
| 25-1716306 | Other | PA | INTERGROUP |
| 2134441 | Other | PA | AETNA HMO |
| 25-1716306 | Other | PA | GREATWEST HEALTHCARE |
| 25-1716306 | Other | PA | DEVON |
| 1007307260034 | Other | PA | MEDICAID GROUP # |
| 25-1716306 | Other | PA | INFORMED |
| 426611 | Other | PA | HEALTH AMERICA |
| 5957727 | Other | PA | AETNA NON-HMO |
| PE085826 | Other | PA | HIGHMARK BLUESHIELD |
| 0017392500005 | Medicaid | PA | |
| 120420420 | Other | PA | DEPT OF LABOR |
| 122865 | Other | PA | UNISON |
| 867633 | Other | PA | MEDICARE GROUP # |
| G920-0027/KDM4PO | Other | PA | CAREFIRST |
| 25-1716306 | Other | PA | SOUTH CENTRAL PREFERRED |
| MD065733L | Other | PA | LICENSE |
| 001739250 0007 | Medicaid | PA | |
| 2117289 | Other | PA | MAMSI |
| 25-1716306 | Other | PA | MULTIPLAN/PHCS |
| 2160082 | Other | PA | FIRST HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Physician Services | Family Medicine | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- tpeterson247404@wellspan.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba WellSpan Summit Physician Services
- Family Medicine Physician
- Chambersburg, PA
- NPI 1306840814
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1023012408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3208 BALTUSROL DR",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172027038",
"telephone_number": "717-860-0890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3208 BALTUSROL DR",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172027038",
"telephone_number": "717-860-0890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TODD",
"middle_name": "VICTOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2023-03-07",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD065733L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET/TRICARE",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUECROSS (EPIQ)",
"identifier": "50059950",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUECROSS (WH)",
"identifier": "50085311",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080135921",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERGROUP",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2134441",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST HEALTHCARE",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVON",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP #",
"identifier": "1007307260034",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INFORMED",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "426611",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON-HMO",
"identifier": "5957727",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUESHIELD",
"identifier": "PE085826",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017392500005",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "120420420",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "122865",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "867633",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "G920-0027/KDM4PO",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH CENTRAL PREFERRED",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "MD065733L",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001739250 0007",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2117289",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN/PHCS",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2160082",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chambersburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.