Individual provider Active NPI

Cameron Scott Peterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Carlsbad, NM
National Provider Identifier
1053827832
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA-01538 Issued in NM
Practice address
2430 W Pierce St
Carlsbad, NM 88220-3553
Phone
(575) 887-4100
NPI assigned
Dec 15, 2017
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA-01538 NM Primary

Addresses

Primary practice location

2430 W Pierce St
Carlsbad, NM 88220-3553

Mailing address

4201 Arcadia PT
Las Cruces, NM 88011-4384
Phone (801) 367-5437

Other identifiers 1

IdentifierTypeStateIssuer
04536819MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180425002355 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719241835 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2550 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (800) 421-8274

2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesiology Associates of NM Inc CurrentSince Dec 30, 2019 Accepting new patients
Three Crosses Regional Hospital LLC CurrentSince Jan 15, 2024 Accepting new patients
Main Street Anesthesia of New Mexico, LLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

2560 Samaritan Dr
Las Cruces, NM 88001
Phone (575) 800-3868

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1053827832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ARCADIA PT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114384",
            "telephone_number": "801-367-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203553",
            "telephone_number": "575-887-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CAMERON",
        "middle_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04536819",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.