Peter J Mayer, DDS,MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D12064 Issued in MN

Practice address

3617 W Arrowhead Rd
Duluth, MN 55811-4046

Phone

(218) 722-8377

Fax

(218) 722-3117

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN, WI2 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

Oral Surgery

Education

University of Connecticut School of Medicine, 2002

Medicare assignment

May accept Medicare assignment

Group practices

Northern Oral and Maxillofacial Surgeons PAGroup PAC ID 3072535863, shared by 2 NPIs, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northern Oral & Maxillofacial Surgeons, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, MN
  • NPI 1457401820
  Medicare reassignment NPD
• Northern Oral & Maxillofacial Surgeons, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Superior, WI
  • NPI 1013068691
  Medicare reassignment NPD
• Northern Oral & Maxillofacial Surgeons, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Hibbing, MN
  • NPI 1588715163
  NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1104976570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 W ARROWHEAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114046",
            "telephone_number": "218-722-8377",
            "fax_number": "218-722-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 W ARROWHEAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114046",
            "telephone_number": "218-722-8377",
            "fax_number": "218-722-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "DDS,MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D12064",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5846",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN MEDICAID",
            "identifier": "33793800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BCBS",
            "identifier": "336G1MA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santiago Mauricio
• Joshua Shane Maxwell, D.O.
• Sally D Maxwell, LP
• Shannon Rachelle May, N.D., L.AC
• Devon Maycock, MSW, LICSW
• Karissa Maynard
• Mostafa Mohamed Ezzat Hamza a Mazen, MD
• Angela Rose McAllister, M.D.
• Mariah Kristine McAndrew, MSW, LICSW
• Ashley McArthur

• Oral and Maxillofacial Surgery (Dentist) in Duluth, MN
• Providers in Duluth, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.