Paul Stephen Peterson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0005173 Issued in CO

Practice address

5731 Silverstone Ter Ste 100
Colorado Springs, CO 80919-3594

Phone

(719) 636-3333

Fax

(719) 636-0025

NPI assigned

May 29, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: ppeterson@98deb2d4.micromddirect.com

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.

• Accelerated Recovery Specialists

  • Specialist
  • Colorado Springs, CO
  • NPI 1568534667
  Medicare reassignment

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1245498971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5731 SILVERSTONE TER STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193594",
            "telephone_number": "719-636-3333",
            "fax_number": "719-636-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5731 SILVERSTONE TER STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193594",
            "telephone_number": "719-636-3333",
            "fax_number": "719-636-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "PAUL",
        "middle_name": "STEPHEN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002714",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0005173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000687068A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leola A Peterson
• Levi Peterson
• Lillian Peterson
• Margaret Peterson
• Melissa Janelle Peterson, LCSW
• Riley Peterson
• Tony Leroy Peterson, DDS
• Tyffanie Peterson
• Maureen Petik
• Anja Petkash, RN

• Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.