John L. Petersen, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD00010656 Issued in WA

Practice address

801 Broadway Ste 808
Seattle, WA 98122-4328

Phone

(206) 292-7990

Fax

(206) 292-4882

NPI assigned

Oct 16, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

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.

• Swedish Health Services

  • Cardiovascular Disease Physician
  • Seattle, WA
  • NPI 1720029028
  Medicare reassignment NPD
• Swedish Health Services

  • Cardiovascular Disease Physician
  • Edmonds, WA
  • NPI 1659328177
  NPD
• Swedish Health Services

  • Surgery Physician
  • Seattle, WA
  • NPI 1053368571
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1306926225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84026",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981248426",
            "telephone_number": "206-292-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY STE 808",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224328",
            "telephone_number": "206-292-7990",
            "fax_number": "206-292-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JOHN",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00010656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8125205",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Petersen, MD
• James T Petersen, DDS
• Jamie Christine Petersen, LMFTA
• Jason Mark Petersen, ND
• Jessica Petersen, RD, CD
• Judy Ann Petersen, COTA
• Julia Lynn Petersen, M.A
• Karen A Petersen, CHP, LMP
• Karla Renee Petersen
• Kimberly Petersen, MA, LMHC

• Cardiovascular Disease Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Cardiovascular Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.