Peter R Nuttleman, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

40778 Issued in WI

Practice address

6750 N Macarthur Blvd Ste 160
Irving, TX 75039-2517

Phone

(469) 283-1217

Fax

(972) 869-5990

NPI assigned

May 22, 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 WI, OR, UT3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 21219-nuttleman-peter@direct.leadingreach.com
• Direct secure messaging: pnuttleman216870@secure.stcharleshealthcare.org

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  WI

  Medicare reassignment NPD
• Ashley Valley Physician Practice, LLC

  • Orthopaedic Surgery Physician
  • Vernal, UT
  • NPI 1740482025
  Medicare reassignment NPD
• Harney District Hospital

  • Critical Access Hospital
  • Burns, OR
  • NPI 1285742338
  Medicare reassignment NPD
• Ashley Valley Physician Practice LLC

  • Durable Medical Equipment & Medical Supplies
  • Vernal, UT
  • NPI 1457195034
  NPD
• Harney District Hospital

  • Rural Health Clinic/Center
  • Burns, OR
  • NPI 1013276195
  NPD
• Harney District Hospital

  • Multi-Specialty Clinic/Center
  • Burns, OR
  • NPI 1972113306
  NPD
• Elite Orthopaedics of Irving PLLC

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1982892105
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1447204409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 N MACARTHUR BLVD STE 160",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392517",
            "telephone_number": "469-283-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 N MACARTHUR BLVD STE 160",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392517",
            "telephone_number": "469-283-1217",
            "fax_number": "972-869-5990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6161 N State Highway 161 Ste 328",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750382220",
            "country_code": "US",
            "telephone_number": "469-283-1217",
            "fax_number": "972-869-5990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "260 26th St",
            "address_purpose": "LOCATION",
            "city": "Prairie Du Sac",
            "state": "WI",
            "postal_code": "535782203",
            "country_code": "US",
            "telephone_number": "608-643-2431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTTLEMAN",
        "first_name": "PETER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "40778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34226100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "007806261J",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angie Nuno, FNP-C
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• Nurturing Family Counseling
• Nutripath Wellness LLC
• Mary Nuxoll, LPC
• Obinna Emeka Nwankwo, D.D.S.
• Linus Nwosu
• Patience N Nwosu, MSN, APRN, FNP-BC
• NXT LVL: Sports Rehab & Performance LLC

• Surgery Physician in Irving, TX
• Providers in Irving, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.