Individual provider Active NPI

Daniel Peterson, FNP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1194411355
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10366644-8900 Issued in UT
Practice address
470 E 3900 S Ste 200
Salt Lake City, UT 84107-2332
Phone
(801) 747-2800
NPI assigned
Apr 12, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10366644-8900 UT Primary

Addresses

Primary practice location

470 E 3900 S Ste 200
Salt Lake City, UT 84107-2332

Mailing address

470 E 3900 S Ste 200
Salt Lake City, UT 84107-2332
Phone (801) 747-2800

Other identifiers 3

IdentifierTypeStateIssuer
260022408OtherUTRAILROAD MEDICARE
8760003008007MedicaidUT
000055266OtherUTMEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20231221000773 UT Practitioner - Nurse Practitioner 8921458647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Utah Endocrinology Associates PLLCGroup PAC ID 0042399172, 7 clinicians

Practice addresses (Care Compare)

470 E 3900
Suite 200
Salt Lake City, UT 84107-2332
Phone (801) 747-2800

Hospital & facility affiliations

  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
  • Evanston Regional Hospital Hospital, Evanston, WY, CCN 531319

Merit-based Incentive Payment System (MIPS)

Final score
91.65 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10366644-8900UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Endocrinology Associates PLLC CurrentSince Nov 7, 2023 Accepting new patients

Locations

470 E 3900 S
Ste 200
Salt Lake Cty, UT 84107
Phone (801) 747-2800

5327 Adams Avenue Pkwy
Ste A
Washington Terrace, UT 84405
Phone (801) 747-2800

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1194411355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 E 3900 S STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072332",
            "telephone_number": "801-747-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 E 3900 S STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072332",
            "telephone_number": "801-747-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANIEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10366644-8900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260022408",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8760003008007",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "000055266",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.