Individual provider Active NPI

Mary S Peterson, ARNP

  • Nurse Practitioner
  • Ft Lauderdale, FL
National Provider Identifier
1235154766
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 2629942 Issued in FL
Practice address
1625 SE 3Rd Ave
Suite 525
Ft Lauderdale, FL 33316-2521
Phone
(954) 355-4975
Fax
(954) 355-5898
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 2629942 FL Primary

Addresses

Primary practice location

1625 SE 3Rd Ave
Suite 525
Ft Lauderdale, FL 33316-2521

Mailing address

1608 SE 3Rd Ave
Third Floor Cbo/PBS
Ft Lauderdale, FL 33316-2564
Phone (954) 847-4273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070524000040 FL Practitioner - Nurse Practitioner 8325145469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1400 NW 12TH Ave
5TH Floor/Micu
Miami, FL 33136-1003
Phone (305) 243-5470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Past Accepting new patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner Past Accepting new patients
University of Miami Past Accepting new patients

Locations

5700 N Federal Hwy
Ste 5
Ft Lauderdale, FL 33308
Phone (305) 776-1800

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

3850 Hollywood Blvd
Hollywood, FL 33021
Phone (954) 251-8873

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mpeterson59031@direct.med.miami.edu

Organizations & group practices 5

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 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1235154766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SE 3RD AVE",
            "address_2": "THIRD FLOOR CBO/PBS",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162564",
            "telephone_number": "954-847-4273",
            "fax_number": "954-847-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE",
            "address_2": "SUITE 525",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-355-4975",
            "fax_number": "954-355-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 2629942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.