Carl E Petersen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15449 Issued in MA

Practice address

446 Newton St
South Hadley, MA 01075-2331

Phone

(413) 536-4730

NPI assigned

Mar 15, 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

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Lerner & Petersen, DDS, PC

  • General Practice Dentistry
  • South Hadley, MA
  • NPI 1013986066
  NPD (past)
• South Hadley Dental Group, LLC

  • Dentist
  • South Hadley, MA
  • NPI 1013493311
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447229216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 NEWTON ST",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010752331",
            "telephone_number": "413-536-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 NEWTON ST",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010752331",
            "telephone_number": "413-536-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "CARL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Gisele Pawlowski, NP
• Edward John Pelc Jr., RPH
• Jose Alfonso Peralta Gonzalez, DMD
• Lauren Ann Perica, D.P.M.
• Rebekah Perks, NP
• Gregory Petrosky, ED.D
• Andy Pham, DPT
• Kelly J Phillips, LICSW
• Pioneer Valley Performing Arts Charter School
• Lyndsey Pisano, OTD

• General Practice Dentistry in South Hadley, MA
• Providers in South Hadley, MA by specialty
• General Practice Dentistry in Massachusetts

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.