NPIMap

Individual provider Active NPI

Christopher Peluso, PA-C

  • Physician Assistant
  • Perham, MN
National Provider Identifier
1073981908
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11967 Issued in MN
Practice address
1000 Coney St W
Perham, MN 56573-3409
Phone
(218) 347-1200
NPI assigned
Sep 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11967 MN Primary

Addresses

Primary practice location

1000 Coney St W
Perham, MN 56573-3409

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 847-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150929001453 MN Practitioner - Physician Assistant 6709194566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perham Hospital DistrictGroup PAC ID 2264327766, 40 clinicians
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1656

1000 Coney W St
Perham, MN 56573-2102

105 Otter Dr
Ottertail, MN 56571-7040
Phone (218) 367-6111

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

Hospital & facility affiliations

  • Perham Health Hospital, Perham, MN, CCN 241373
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
91.62
Promoting interoperability
100
Improvement activities
40
Cost
66.36

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11967MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Perham Hospital District CurrentSince Aug 29, 2022 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jun 12, 2023 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jun 12, 2023 Accepting new patients
Sanford Clinic North Past Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

105 Otter Dr
Ottertail, MN 56571
Phone (218) 367-6111

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1073981908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565733409",
            "telephone_number": "218-347-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1027 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit Lakes",
            "state": "MN",
            "postal_code": "565013409",
            "country_code": "US",
            "telephone_number": "218-847-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELUSO",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

Verify at the official NPI Registry.