Peggy B Petersen
Individual provider Active NPI Anesthesiology Physician · Salt Lake City, UT
NPI 1245238104 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1245238104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 1748333-1205 (UT)
- Practice address
- 3838 S 700 E
Ste 200
Salt Lake City, UT 84106-1466 - Phone
- (801) 261-4988
- Fax
- (801) 269-9427
- NPI assigned
- Jul 13, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- University of Utah School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Millcreek Anesthesia PC
Practice addresses (Care Compare)
1200 E 3900
St Marks Hospital
Salt Lake City, UT 84124-1300
Phone (801) 268-7111
Hospital & facility affiliations
- St Mark'S Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050426001025 | UT | Practitioner - Anesthesiology | 1456255256 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1748333-1205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millcreek Anesthesia PC | Anesthesiology | Current |
Accepting new patients |
| Omega Interventional Pain PLLC | Past | Accepting new patients | |
| Lifetree Medical Inc | Anesthesiology | Past | Accepting new patients |
| Sevocation Anesthesia, PLLC | Anesthesiology | Past | Accepting new patients |
Locations
1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 1748333-1205 | UT | Yes |
Addresses
Primary practice location
3838 S 700 E
Ste 200
Salt Lake City, UT 84106-1466
Mailing address
PO Box 27688
Salt Lake City, UT 84127-0688
Phone (801) 534-1360
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08517 | Medicaid | UT |
Other providers in Salt Lake City, UT
- Kellie Maria Petersen
- Kimberly Petersen
- Lacy Petersen
- Marilyn J Petersen
- Marta J Petersen
- Ray Albert Petersen
- Samantha Petersen
- Scott D Petersen Jr.
- Sydnee Petersen
- Aaron Peterson
All providers in Salt Lake City, UT · Anesthesiology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.