Andrew Albert Peterson, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

M-13255 Issued in ID

Practice address

190 E Bannock St
Boise, ID 83712-6241

Phone

(208) 381-2094

Fax

(208) 381-1791

NPI assigned

Jun 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Specialty

Interventional Radiology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians

Boise Radiology Group PLLCGroup PAC ID 9638153257, 64 clinicians

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
• St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071
• St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
• St Luke'S Elmore Medical Center Hospital, Mountain Home, ID, CCN 131311
• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

81.29

Promoting interoperability

100

Improvement activities

40

Cost

76.37

Merit-based Incentive Payment System (MIPS)

Final score

93.94 of 100Reported as group

Quality

92.87

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apeterson62449@direct.slhs.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.

• Boise Radiology Group PLLC

  • Diagnostic Radiology Physician
  • Boise, ID
  • NPI 1740216175

  Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• Weiser Valley Hospital District

  • Family Medicine Physician
  • Weiser, ID
  • NPI 1255364030
  Medicare reassignment Care Compare group NPD
• North Canyon Medical Center Inc.

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment NPD
• North Canyon Medical Center, Inc.

  • Rural Health Clinic/Center
  • Buhl, ID
  • NPI 1568950566
  NPD
• North Canyon Medical Center, Inc.

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• Weiser Valley Hospital District

  • Critical Access Hospital
  • Boise, ID
  • NPI 1639373772

  Vascular & Interventional Radiology

  NPD
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

• St Lukes Regional Medical Center

  • Ambulance
  • Mountain Home, ID
  • NPI 1477954204

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • Critical Access Hospital
  • Mountain Home, ID
  • NPI 1699013565
  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes West LTD

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation
• St Lukes Wood River Medical Center LTD

  • Critical Access Hospital
  • Ketchum, ID
  • NPI 1508869470
  Care Compare affiliation
• St. Luke'S Magic Valley Regional Medical Center, LTD.

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1083842033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2094",
            "fax_number": "208-381-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2094",
            "fax_number": "208-381-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANDREW",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ID",
            "license": "M-13255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Petersen, MD
• Sarah Brienne Petersen
• Peterson Family Dentistry
• Peterson Thrive Therapy
• Lauri Peterson Peterson-Carey
• Anna Jeannette Peterson, DO
• Christian Peterson, MD
• Conner Peterson, PHARMD
• Forrest Read Peterson
• Jamie Brooke Peterson, PA-C

• Vascular & Interventional Radiology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Vascular & Interventional Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.