NPIMap

Individual provider Active NPI

Lance Petersen, MD

  • Emergency Medicine Physician
  • Powell, WY
National Provider Identifier
1245303429
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00035749 Issued in WA
Practice address
777 Avenue H
Powell, WY 82435-2260
Phone
(307) 754-2267
Fax
(307) 754-7747
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 8006A WY
Emergency Medicine Physician 207P00000X MD00035749 WA Primary
Family Medicine Physician 207Q00000X MD00035749 WA

Addresses

Primary practice location

777 Avenue H
Powell, WY 82435-2260

Mailing address

777 Avenue H
Powell, WY 82435-2260
Phone (307) 754-2267

Other practice location 1

110 Hospital Lane
Afton, WY 83110-0579
Phone (307) 885-5800

Other identifiers 1

IdentifierTypeStateIssuer
8232787MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040310001154 WA Practitioner - Family Practice 3072401959 Reassigns benefits to 2 organizations
I20241012000253 ND Practitioner - Family PracticePractitioner - Emergency Medicine 3072401959 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1300

Hospital & facility affiliations

  • CHI St Alexius Health Devils Lake Hospital, Devils Lake, ND, CCN 351333
  • Island Hospital Hospital, Anacortes, WA, CCN 500007
  • Jamestown Regional Medical Center Hospital, Jamestown, ND, CCN 351335
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

Merit-based Incentive Payment System (MIPS)

Final score
33.71 of 100Reported as group
Quality
39.66
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00035749WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Hospital and Health Center CurrentSince Dec 29, 2024 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Feb 18, 2026 Accepting new patients
Lutheran Charity Association Current Accepting new patients
St Joseph'S Hospital and Health Center Current Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Oct 31, 2024 Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Dec 29, 2024 Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Lutheran Charity Association Emergency Medicine CurrentSince Jun 13, 2025 Accepting new patients
Lutheran Charity Association CurrentSince Jun 13, 2025 Accepting new patients
Mercy Hospital of Devils Lake Emergency Medicine CurrentSince Oct 31, 2024 Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Past Accepting new patients
Teton Valley Health Care Inc Past Accepting new patients
Altru Health System Family Medicine Past Accepting new patients

Locations

3290 Solutions Ctr
Chicago, IL 60677

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 9

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1245303429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-2267",
            "fax_number": "307-754-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-2267",
            "fax_number": "307-754-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Hospital Lane",
            "address_purpose": "LOCATION",
            "city": "Afton",
            "state": "WY",
            "postal_code": "831100579",
            "country_code": "US",
            "telephone_number": "307-885-5800",
            "fax_number": "307-885-5865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "8006A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00035749",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00035749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8232787",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.