Robert L Peterson, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD7087 Issued in HI

Practice address

1319 Punahou St
1070
Honolulu, HI 96826-1001

Phone

(808) 944-8551

Fax

(808) 955-5667

NPI assigned

Jan 9, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Robert L. Peterson, Inc.

  dba Athena Group

  • Plastic Surgery Physician
  • Honolulu, HI
  • NPI 1598719916
  NPD (past) Authorized official
• Disu Hawaii Inc

  dba Athena Clinic

  • Plastic and Reconstructive Surgery Physician
  • Honolulu, HI
  • NPI 1295423119
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204934400000",
    "number": "1407905524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "address_2": "1070",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-944-8551",
            "fax_number": "808-955-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "address_2": "1070",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-944-8551",
            "fax_number": "808-955-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "HI",
            "license": "MD7087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD HI",
            "identifier": "91264",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn M Peterson, DO
• Jeffrey Peterson, MD
• Jill C Peterson, PSY.D.
• Laura D. Peterson, M.D.
• Lenore Dianne Peterson
• Susie Bartolome Peterson, CSCD CCC-SLP
• Colin Petko, M.D.
• Maria Petkus
• Judy D Petretee, PT
• Mara M M Petrie, DPT

• Plastic Surgery Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Plastic Surgery Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2008; 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.