Jennifer Petersen-Goldspiel, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

01059768A Issued in IN

Practice address

1312 W. Arch Haven Avenue
Bloomington, IN 47403

Phone

(812) 676-4144

Fax

(812) 339-8344

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Petersen Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Cardiovascular Disease (Cardiology)

Education

Rush Medical College of Rush University, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
• Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
• Indiana University Health Paoli Hospital Hospital, Paoli, IN, CCN 151306
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112

Merit-based Incentive Payment System (MIPS)

Final score

86.93 of 100Reported as individual

Quality

75.59

Promoting interoperability

98

Improvement activities

40

Cost

73.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpetersen@yourcarecommunity.org
• Direct secure messaging: jpeter12@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

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

• Columbus Regional Hospital

  • General Acute Care Hospital
  • Columbus, IN
  • NPI 1104998624
  Care Compare affiliation
• 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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1104821974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47402",
            "telephone_number": "812-353-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 W. ARCH HAVEN AVENUE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47403",
            "telephone_number": "812-676-4144",
            "fax_number": "812-339-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN-GOLDSPIEL",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01059768A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200495150",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PETERSEN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tashera Everlois Narcissa Perry
• Carol J Persley, LCSW
• Lainey Peter
• Allison V Peters, PA-C
• Asia Peters
• Laura Petersen, LCSW
• Elizabeth Peterson, OT
• Erica Christine Peterson, RN
• Courtney Petrie
• Misty Susanne Petro, PTA,ATC,CSCS

• Cardiovascular Disease Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Cardiovascular Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.