Gregory Matthew Peterson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

55134 Issued in MN

Practice address

500 S Maple St
Empac, Ridgeview Medical Center
Waconia, MN 55387-1752

Phone

(952) 442-2191

NPI assigned

Jun 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Emergency Medicine

Education

University of Minnesota Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429

  MN

  Medicare reassignment Care Compare group NPD
• Minnesota Valley Health Center Inc

  • Critical Access Hospital
  • Le Sueur, MN
  • NPI 1730248907

  MN

  Medicare reassignment NPD
• Sibley Medical Center

  • Critical Access Hospital
  • Arlington, MN
  • NPI 1740240225

  MN

  Medicare reassignment NPD
• Minnesota Valley Health Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Le Sueur, MN
  • NPI 1215097902
  NPD
• Ridgeview Medical Center

  • Urgent Care Clinic/Center
  • Chanhassen, MN
  • NPI 1558142869
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457

  Hospital

  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1245467141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "address_2": "EMPAC, RIDGEVIEW MEDICAL CENTER",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "address_2": "EMPAC, RIDGEVIEW MEDICAL CENTER",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GREGORY",
        "middle_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "55134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon James Penaz, DDS
• Abbigail Pepka
• Brittney J Perlich, CCC - SLP
• Kelly Ann Peters, MA OTR/L
• Kirstin Amber Peters, MS, OTR/L
• Mark C Peterson
• Boriana I Petkov, MD
• Robin Lee Petrich, APRN
• To Uyen T Pham
• Cody Ray Plaisance, PA

• All providers in Waconia, MN
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.