David Alan Peterson, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

2008-00797 Issued in NC

Practice address

9633 Bitter Melon Dr
Angier, NC 27501-5917

Phone

(919) 639-8900

Fax

(919) 639-9500

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, IN2 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 2

Specialty

Vascular Surgery

Education

University of Michigan Medical School, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
• Indiana University Health Paoli Hospital Hospital, Paoli, IN, CCN 151306

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpeterson7@direct.iuhealth.org

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  Medicare reassignment Care Compare group
• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641

  Surgery

  Medicare reassignment NPD
• DLP Western Carolina Physician Practices LLC

  • Diagnostic Radiology Physician
  • Clyde, NC
  • NPI 1932925062
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Bedford, Inc

  • Critical Access Hospital
  • Bedford, IN
  • NPI 1548260284
  Care Compare affiliation
• Indiana University Health Bedford, Inc.

  • Ambulance
  • Bedford, IN
  • NPI 1346218799

  Hospital

  Care Compare affiliation
• Indiana University Health Bloomington Inc

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1205860335
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation
• Indiana University Health Paoli Inc

  • Critical Access Hospital
  • Paoli, IN
  • NPI 1912984451
  Care Compare affiliation

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1023230729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 BITTER MELON DR",
            "city": "ANGIER",
            "state": "NC",
            "postal_code": "275015917",
            "telephone_number": "919-639-8900",
            "fax_number": "919-639-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9633 BITTER MELON DR",
            "city": "ANGIER",
            "state": "NC",
            "postal_code": "275015917",
            "telephone_number": "919-639-8900",
            "fax_number": "919-639-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Landmark Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474033239",
            "country_code": "US",
            "telephone_number": "812-355-6900",
            "fax_number": "812-339-1292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A87648",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01080233A",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2008-00797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A876480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chirag Patel, PHARMD
• Jaimita V Patel, M.D.
• Venu Patel, DMD
• Nikita Peoples, RN
• Lourdes Amparo Pereda, MD
• Phlebotomy Training Institute & Resource
• Phoenix Life Empowerment Foundation
• Primrose Villa
• Primrose Villa
• Primrose Villa

• Vascular Surgery Physician in Angier, NC
• Providers in Angier, NC by specialty
• Vascular Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.