Active NPI
Suzy E Peterson, DO
- Child & Adolescent Psychiatry Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 45096
- Practice address
- 2450 Riverside Ave
Minneapolis, MN 55454-1512 - Phone
- (612) 672-6000
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 45096 | MN | Primary |
Addresses
Primary practice location
2450 Riverside Ave
Minneapolis, MN 55454-1512
Mailing address
2353 Youngman Ave
Saint Paul, MN 55116-3021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
550 Snelling Ave S
Suite 203
Saint Paul, MN 55116-1578
Phone (651) 698-4443
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45096 | MN | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Highland Psychiatric Services PA | Child & Adolescent Psychiatry | Current | Accepting new patients |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients |
Locations
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273
550 Snelling Ave S
Ste 203
Saint Paul, MN 55116
Phone (651) 698-4443
Organizations & group practices 10
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.
-
- Child & Adolescent Psychiatry Physician
- St Paul, MN
- NPI 1891884326
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Clinic/Center
- Vadnais Heights, MN
- NPI 1639125503
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Specialist
- Wyoming, MN
- NPI 1346587805
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Family Medicine Physician
- Wyoming, MN
- NPI 1417037896
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- Internal Medicine Physician
- Saint Paul, MN
- NPI 1508191552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114961372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2353 YOUNGMAN AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551163021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541512",
"telephone_number": "612-672-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SUZY",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MN",
"license": "45096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.