Nils W Peterson, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

113052 Issued in NY

Practice address

200 Madison Ave
Elmira, NY 14901-3218

Phone

(607) 734-1581

Fax

(607) 767-4137

NPI assigned

Jun 7, 2006

Last updated

Apr 16, 2014By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Advantagehealth Medical Services, PC

  • Nephrology Physician
  • Elmira, NY
  • NPI 1558342477

  Otolaryngology

  NPD (past)
• Arnot Ogden Medical Center

  • General Acute Care Hospital
  • Elmira, NY
  • NPI 1083605661
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1386684488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052435",
            "telephone_number": "607-271-2093",
            "fax_number": "607-271-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MADISON AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013218",
            "telephone_number": "607-734-1581",
            "fax_number": "607-767-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "NILS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "113052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00358296",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Perkins, MS, OTR/L
• Mary Jo Perkins, RN
• Looknarine Persaud, M.D.
• Christa Louise Perz, LCSW
• Nan Peterson
• Rebecca Susan Pettibone, NP
• Lisa Peworchik
• Vu Linh Pham, M.D.
• Brittnie Phan
• Casey Phifer, MA

• Otolaryngology Physician in Elmira, NY
• Providers in Elmira, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.