Brian G Peterson, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

2006019887 Issued in MO

Practice address

10012 Kennerly Rd
Suite 305
Saint Louis, MO 63128-2197

Phone

(314) 525-4325

Fax

(314) 525-4365

NPI assigned

Aug 4, 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 MO

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

Specialty

Vascular SurgeryAlso: General Surgery

Education

Saint Louis University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiothoracic Surgery, LLCGroup PAC ID 1254365281, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
• Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Merit-based Incentive Payment System (MIPS)

Final score

92.71 of 100Reported as apm

Quality

82.25

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Cardiothoracic Surgery, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chesterfield, MO
  • NPI 1104895812
  Medicare reassignment Care Compare group NPD

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

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Phelps County Regional Medical Center

  • Rural Health Clinic/Center
  • Salem, MO
  • NPI 1194077701

  Hospital

  Care Compare affiliation
• Phelps County Regional Medical Center

  • Rehabilitation Hospital Unit
  • Rolla, MO
  • NPI 1346287455
  Care Compare affiliation
• Phelps County Regional Medical Center

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Care Compare affiliation
• Poplar Bluff Regional Medical Center LLC

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724
  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1356359376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 305",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-4325",
            "fax_number": "314-525-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 305",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-4325",
            "fax_number": "314-525-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRIAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2006019887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356329376",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William C Petersen, PH.D.
• Danielle Lee Petersmith, CRNA
• Alexandria Elizabeth Peterson, PA
• Andrew Michael Peterson, MD
• Annahita Peterson, MD, MSCI
• Casey Michelle Peterson, O.D.
• Chelsea Marie Peterson, DPT
• Christine Marie Peterson, MD
• Christopher M Peterson, DPT
• Collin Peterson

• Vascular Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Vascular Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.