Charles John Peterson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

21030 Issued in AZ

Practice address

5301 E Grant Road
Tucson Medical Center Emergency Department
Tucson, AZ 85712-2805

Phone

(520) 324-1922

Fax

(520) 324-1088

NPI assigned

Oct 26, 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 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Emergency Medicine

Education

Oregon Health Sciences University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ies Arizona PLLCGroup PAC ID 7810382884, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Merit-based Incentive Payment System (MIPS)

Final score

97.68 of 100Reported as group

Quality

92.69

Promoting interoperability

100

Improvement activities

40

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.

• Ies Arizona PLLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1821752213
  Medicare reassignment Care Compare group NPD
• Ies Obs Arizona PLLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1356006670
  Medicare reassignment NPD
• Swea, P.C.

  dba Southwest Emergency Associates, P.C.

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407953573
  NPD (past)

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437234499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 E PIMA STREET",
            "address_2": "SUITE B",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857125601",
            "telephone_number": "520-382-2819",
            "fax_number": "520-382-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT ROAD",
            "address_2": "TUCSON MEDICAL CENTER EMERGENCY DEPARTMENT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-324-1922",
            "fax_number": "520-324-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHARLES",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "21030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "150384",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15038402",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivien Ann Petersen, R.N.
• Amber Lynn Peterson, PMHNP
• Andrea Deanne Peterson, LMT
• Arleen Peterson, MD
• Bart C Peterson, ATC
• Christopher Luke Peterson, D.O.
• Douglas Peterson, MD
• Erin Peterson, PT
• Gary Jack Peterson, LAC-23090
• Gary S Peterson, DDS

• Emergency Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.