NPIMap

Individual provider Active NPI

Edward A Pelton, MD

  • Family Medicine Physician
  • Chadron, NE
National Provider Identifier
1255314654
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18841 Issued in NE
Practice address
825 Centennial Dr
Chadron, NE 69337-9400
Phone
(308) 432-4441
Fax
(308) 432-2130
NPI assigned
Nov 21, 2005
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18841 NE Primary

Addresses

Primary practice location

825 Centennial Dr
Chadron, NE 69337-9400

Mailing address

825 Centennial Dr
PO Box 431
Chadron, NE 69337-9400
Phone (308) 432-4441

Other identifiers 2

IdentifierTypeStateIssuer
18841OtherNESTATE LICENSE NUMBER
00081OtherNEBLUE SHIELD PROVIDER NUMB

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050120000903 NE Practitioner - Family Practice 1759290232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chadron Medical Clinic PCGroup PAC ID 8022086453, 11 clinicians

Practice addresses (Care Compare)

825 Centennial Dr
Chadron, NE 69337-9400
Phone 30843244412306

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.23 of 100Reported as individual
Quality
58.6
Promoting interoperability
99
Improvement activities
40
Cost
56.32

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions56
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chadron Community Hospital Corp. CurrentSince May 26, 2014 Accepting new patients
Chadron Community Hospital Corp. Family Medicine Past Accepting new patients
Chadron Medical Clinic PC Family Medicine Past Accepting new patients
City of Crawford Past Accepting new patients
Kismet CDR, LLC Past Accepting new patients

Locations

825 Centennial Dr
Chadron, NE 69337
Phone (308) 432-4441

11 Paddock St
Crawford, NE 69339
Phone (308) 665-1770

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ponderosa VillaCrawford, NE, CCN 285250 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2025
Aug 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • City of Crawford

    dba Ponderosa Villa

    • Skilled Nursing Facility
    • Crawford, NE
    • NPI 1922033273

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1255314654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CENTENNIAL DR",
            "address_2": "PO BOX 431",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693379400",
            "telephone_number": "308-432-4441",
            "fax_number": "308-432-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CENTENNIAL DR",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693379400",
            "telephone_number": "308-432-4441",
            "fax_number": "308-432-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTON",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "18841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "18841",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMB",
            "identifier": "00081",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chadron, NE

Sources for this page

Verify at the official NPI Registry.