Mary E Peterson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP2970 Issued in AZ

Practice address

901 W Ben White Blvd
Austin, TX 78704-6903

Phone

(512) 816-8611

Fax

(512) 816-6171

NPI assigned

Feb 12, 2008

Last updated

Dec 13, 2016By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Health Science Center at Tyler-Facilty-PhysicianGroup PAC ID 4981699220, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.peterson@hca8.eclinicaldirectplus.com
• Direct secure messaging: mpeterson1347628@ahs.direct-ci.com

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.

• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  dba UT Health East Texas Physicians Overton

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1174791115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W BEN WHITE BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046903",
            "telephone_number": "512-816-8611",
            "fax_number": "512-816-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W BEN WHITE BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046903",
            "telephone_number": "512-816-8611",
            "fax_number": "512-816-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308127",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Nicole Peterson, OTD, OTR, IBCLC
• Kari Ann Peterson
• Lindsay W Peterson, D.D.S
• Louis Peterson, MD
• Mark A. Peterson, L.P.C.
• Natalie Peterson, LCSW
• Rosemary G Peterson, MD
• Sofia Noelle Peterson
• Christopher Michael Petiprin
• Abagail Elizabeth Petit, PA-C

• Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.