Individual provider Active NPI

Tiffany Peterson, M.D.

  • Emergency Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1205102316
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
FP5103849 Issued in AK
Practice address
MSC 10 5560
University of New Mexico
Albuquerque, NM 87131-0001
Phone
(505) 272-5062
Fax
(505) 272-6503
NPI assigned
Mar 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X FP5103849 AK Primary

Addresses

Primary practice location

MSC 10 5560
University of New Mexico
Albuquerque, NM 87131-0001

Mailing address

MSC 10 5560
University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-5062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150803001167 AK Practitioner - Emergency Medicine 7315172681 Reassigns benefits to 1 organization
I20151125000197 TX Practitioner - Emergency Medicine 7315172681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.68 of 100Reported as group
Quality
84.45
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Oct 15, 2015 Accepting new patients
Alaska Emergency Medicine Associates Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1205102316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC 10 5560",
            "address_2": "UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-5062",
            "fax_number": "505-272-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC 10 5560",
            "address_2": "UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-5062",
            "fax_number": "505-272-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TIFFANY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AK",
            "license": "FP5103849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.