Millicent Rose Peterson, AU.D., CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

003037-01 Issued in NY

Practice address

30 Matthews St Ste 203
Goshen, NY 10924-1985

Phone

(845) 294-8544

NPI assigned

Aug 9, 2021

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Millicent Rose Quevedo Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Valley Audiology PCGroup PAC ID 9739315003, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hudson Valley Audiology PC

  • Audiologist-Hearing Aid Fitter
  • Pomona, NY
  • NPI 1841624517
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1164197570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TERRACE LN",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131333",
            "telephone_number": "845-709-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MATTHEWS ST STE 203",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241985",
            "telephone_number": "845-294-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MILLICENT",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00115300",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "003037-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILLICENT",
            "last_name": "QUEVEDO",
            "middle_name": "ROSE",
            "prefix": "DR.",
            "credential": "AU.D, CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peptide Health Groupllc (Peptide Health of New York)
• Angela M. Perales, LCSW
• Jenesis NA Perez
• Kathleen E Perkins, COTA
• Shelley Ann Perry, COTA
• Lauren Elizabeth Petriski, MS, CAS
• Casey Susan Petronella, DO
• Jill Petry, P.T.
• Virginia Anne Petzold, DC
• Jessica Phair, FNP

• Audiologist in Goshen, NY
• Providers in Goshen, NY by specialty
• Audiologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.