Carly Elizabeth Peterson, MD, FRCPC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD60556882 Issued in WA

Practice address

1100 9TH Ave
Seattle, WA 98101-2756

Phone

(206) 223-6980

Fax

(206) 223-6982

NPI assigned

Aug 9, 2011

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

Medicare fee-for-service enrollment

Enrolled in WA

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

Anesthesiology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Wa Anesthesia Services, PCGroup PAC ID 9335298884, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Merit-based Incentive Payment System (MIPS)

Final score

74.5 of 100Reported as group

Quality

70

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpeterson1342159@wm.providencedirect.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.

• Providence Wa Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Everett, WA
  • NPI 1669615894
  Medicare reassignment Care Compare group NPD

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

• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1124307046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6980",
            "fax_number": "206-223-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6980",
            "fax_number": "206-223-6982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-598-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CARLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD, FRCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60556882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124307046",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Whittaker Hirst Peterson, M.S., CCC-SLP
• Amanda Peterson, MAC
• Anne Elizabeth Peterson, CTRS
• Ashley Peterson
• Bayley Peterson
• Catherine Peterson
• Charles A Peterson II, M.D.
• Charles Mark Peterson, R.N.
• Chelsea Ann Peterson, LAC, MACOM, RN
• Christian Movall Peterson, D.O.

• Anesthesiology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Anesthesiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.