NPIMap

Individual provider Active NPI

Dennis Lee Peterson, M.D.

  • Internal Medicine Physician
  • Kalispell, MT
National Provider Identifier
1205986460
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MED-PHYS-LIC-4557 Issued in MT
Practice address
705 6TH Avenue East
Kalispell, MT 59901-5047
Phone
(406) 755-7366
Fax
(406) 755-7277
NPI assigned
Jan 11, 2007
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MED-PHYS-LIC-4557 MT Primary

Addresses

Primary practice location

705 6TH Avenue East
Kalispell, MT 59901-5047

Mailing address

705 6TH Ave E
Kalispell, MT 59901
Phone (406) 755-7366

Other practice location 1

5 4th Ave E
Polson, MT 59860-2117
Phone (406) 745-3525

Other identifiers 1

IdentifierTypeStateIssuer
0143754MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040324001493 MT Practitioner - Internal Medicine 4789575945 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nebraska College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

35401 Mission Dr
Saint Ignatius, MT 59865-7791
Phone (406) 745-3525

5 4TH Ave E
Polson, MT 59860-2117
Phone (406) 745-3525

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty County Hospital and Nursing Home, Inc Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Liberty County Hospital and Nursing Home, Inc CurrentSince Jul 5, 2023 Accepting new patients
Northern Rockies Medical Center, Inc. CurrentSince Jul 5, 2023 Accepting new patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Mar 1, 2011 Accepting new patients
Northern Rockies Medical Center, Inc. CurrentSince Jul 5, 2023 Accepting new patients
Confederated Salish and Kootenai Tribes of the Flathead Reservation CurrentSince Feb 22, 2024 Accepting new patients
Logan Health - Whitefish Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

226 9th Ave SE
Cut Bank, MT 59427
Phone (406) 873-4941

802 2nd St SE
Cut Bank, MT 59427
Phone (406) 873-2251

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

75 Claremont St
Ste H
Kalispell, MT 59901
Phone (406) 752-7406

5 4th Ave E
Polson, MT 59860
Phone (406) 883-5541

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1205986460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 6TH AVE E",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "59901",
            "telephone_number": "406-755-7366",
            "fax_number": "406-755-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 6TH AVENUE EAST",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015047",
            "telephone_number": "406-755-7366",
            "fax_number": "406-755-7277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 4th Ave E",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "598602117",
            "country_code": "US",
            "telephone_number": "406-745-3525",
            "fax_number": "406-226-2647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DENNIS",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-4557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143754",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "705 6th Ave E",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599015008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.