NPIMap

Individual provider Active NPI

Douglas Edward Peterson, DO

  • Orthopaedic Surgery Physician
  • Danvers, MA
National Provider Identifier
1477535896
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
153208 Issued in MA
Practice address
4 State Rd
Danvers, MA 01923-2567
Phone
(978) 774-3400
Fax
(978) 774-5883
NPI assigned
Nov 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 153208 MA Primary

Addresses

Primary practice location

4 State Rd
Danvers, MA 01923-2567

Mailing address

4 State Rd
Danvers, MA 01923-2567
Phone (978) 774-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000238 MA Practitioner - Orthopedic Surgery 6305030503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of New England, College of Osteo Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Douglas E Peterson LLCGroup PAC ID 3678724325, 3 clinicians

Practice addresses (Care Compare)

4 State Rd
Danvers, MA 01923-2567
Phone (978) 774-3400

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Beth Israel Lahey Health at Home Home health agency, Beverly, MA, CCN 227495
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement13
Lower limb (leg) arthroscopy (minimally invasive joint repair)14
Upper limb (arm) arthroscopy (minimally invasive joint repair)20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
153208MAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Center for Orthopedic Surgery & Sports Medicine LLC Orthopaedic Surgery Current Accepting new patients
Douglas Peterson LLC Orthopaedic Surgery Current Accepting new patients
Douglas E. Peterson, LLC CurrentSince Oct 1, 2012 Accepting new patients
North Shore Center for Orthopedic Surgery Orthopaedic Surgery Current Accepting new patients
Peterson Sports Therapy LLC PastSince Mar 1, 2021 Accepting new patients

Locations

4 State Rd
Danvers, MA 01923
Phone (978) 774-3400

100 Highland Ave
Ste 101
Salem, MA 01970
Phone (978) 745-0820

Interoperability endpoints

  • Direct secure messaging: peterson.douglas.nscos@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1132444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1477535896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-774-3400",
            "fax_number": "978-774-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-774-3400",
            "fax_number": "978-774-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DOUGLAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-20",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "153208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.