NPIMap

Individual provider Active NPI

Michael E Peterson, M.D.

  • Radiation Oncology Physician
  • Yankton, SD
National Provider Identifier
1336238757
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4826 Issued in SD
Practice address
1115 W 9TH St
Yankton, SD 57078-3310
Phone
(605) 668-8850
Fax
(605) 668-9448
NPI assigned
Oct 12, 2006
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 4826 SD Primary

Addresses

Primary practice location

1115 W 9TH St
Yankton, SD 57078-3310

Mailing address

1000 W 4TH St
Suite 12
Yankton, SD 57078-3730
Phone (605) 274-2178

Other identifiers 5

IdentifierTypeStateIssuer
1580614OtherSDARAZ
4826OtherSDDAKOTACARE
236639OtherSDMIDLANDS CHOICE
7200512MedicaidSD
01030622OtherSDPREFERRED ONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20080227000021 SD Practitioner - Radiation Oncology 8921080086 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1000 E 23Rd St
Sioux Falls, SD 57105-2134

1000 W 4TH St
Suite 8
Yankton, SD 57078-3700

1115 W 9TH St
Yankton, SD 57078-3310
Phone (605) 668-9044

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8795

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4826SDMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 3, 2017 Accepting new patients
Avera St Marys CurrentSince Nov 6, 2020 Accepting new patients
Avera McKennan CurrentSince Jul 3, 2017 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2008 Accepting new patients
Avera Queen of Peace CurrentSince Dec 30, 2019 Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2008 Accepting new patients
Avera Queen of Peace CurrentSince Dec 30, 2019 Accepting new patients
Avera St Marys Current Accepting new patients
Avera McKennan Current Accepting new patients
Avera St Marys CurrentSince Nov 6, 2020 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Avera Queen of Peace Current Accepting new patients
Michael E Peterson MD PC Radiation Oncology PastSince Jun 2, 2004 Accepting new patients

Locations

400 22nd Ave
Brookings, SD 57006
Phone (605) 692-6236

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

605 N Foster St
Mitchell, SD 57301
Phone (605) 995-5756

1000 W 4th St
Ste 10
Yankton, SD 57078
Phone (605) 665-9371

1115 W 9th St
Yankton, SD 57078
Phone (605) 668-8327

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Interoperability endpoints

  • Direct secure messaging: michael.peterson@directaddress.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1336238757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 4TH ST",
            "address_2": "SUITE 12",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783730",
            "telephone_number": "605-274-2178",
            "fax_number": "605-668-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W 9TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783310",
            "telephone_number": "605-668-8850",
            "fax_number": "605-668-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SD",
            "license": "4826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "1580614",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "4826",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "236639",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200512",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "01030622",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.