Mark Peterson, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

3006 Issued in AZ

Practice address

1200 N Beaver St
Flagstaff, AZ 86001-3118

Phone

(928) 380-0476

Fax

(928) 214-3882

NPI assigned

Jan 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 TX

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

Merit-based Incentive Payment System (MIPS)

Final score

76.21 of 100Reported as group

Quality

70.63

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Winslow, AZ
  • NPI 1184729493

  TX

  Medicare reassignment NPD
• Dilkon Medical Center

  • Federal Public Health Clinic/Center
  • Dilkon, AZ
  • NPI 1306016126
  NPD
• Winslow Indian Health Care Center, Inc

  dba Winslow Indian Health Care Ambulance

  • Land Ambulance
  • Winslow, AZ
  • NPI 1477827368
  NPD
• Professional Pathology Associates, PC

  • Specialist
  • Flagstaff, AZ
  • NPI 1417130949
  NPD (past)
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  NPD (past)
• Willard Emergency Physicians

  • Emergency Medicine Physician
  • Cottonwood, AZ
  • NPI 1598714743
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295881274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N SAN FRANCISCO ST STE D",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013259",
            "telephone_number": "928-380-0476",
            "fax_number": "928-214-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-380-0476",
            "fax_number": "928-214-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Peterson, DDS MSD
• Jennifer C Peterson, M.D.
• Kathryn Louise Peterson, LCSW
• Lindsey Peterson, NCSP
• Lorin Dean Peterson, DMD
• Royce T Peterson, D.M.D.
• Brittany Petrick, L.AC, MSOM
• Dawn L Pfeffer, PT
• Quan Minh Pham, PHARM.D.
• Phillip a Williams MD, PC (Phillip A Williams MD)

• Emergency Medicine Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.