Nicolas Lee Peters, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD2017-0087 Issued in NM

Practice address

2204 S Dobson Rd Ste 102
Mesa, AZ 85202-6457

Phone

(480) 485-5166

Fax

(877) 991-6652

NPI assigned

Aug 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH, AZ, TX3 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

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.

• Sierra Vista Regional Health Center Medical Group LLC

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1043575483

  Pediatrics

  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment NPD
• Muskingum Valley Health Centers

  • Primary Care Clinic/Center
  • Malta, OH
  • NPI 1205018348
  Medicare reassignment NPD
• Pediatric Academic Association, Inc.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1063419943
  Medicare reassignment NPD
• Pimri, LLC

  • Pediatrics Physician
  • Mesa, AZ
  • NPI 1225660467
  NPD Authorized official
• Muskingum Valley Health Centers

  • Primary Care Clinic/Center
  • Byesville, OH
  • NPI 1568088607
  NPD
• Muskingum Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Zanesville, OH
  • NPI 1851285019
  NPD
• Muskingum Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Coshocton, OH
  • NPI 1902237084
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1487844791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S VAL VISTA DR STE A3-618",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961374",
            "telephone_number": "480-485-5166",
            "fax_number": "877-991-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S DOBSON RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026457",
            "telephone_number": "480-485-5166",
            "fax_number": "877-991-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "NICOLAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "AZ",
            "license": "48190",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "48190",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.094612",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "OH",
            "license": "35.094612",
            "primary": false
        },
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "48190",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NM",
            "license": "MD2017-0087",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2017-0087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "845215",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98035339",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070938",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pete S Coury MD PLLC
• Becky Jean Peters, MA CCC-SLP
• Cynthia Ann Peters, CRNFA, FNP-C
• Darrell Wayne Peters, D.O.
• Morgan Peters, DPT
• Tycee Peters, MSW
• Alan Mark Petersen, D.D.S.
• Arlon M Petersen, DMD
• Brett Petersen, LMSW
• Brittney Marie Petersen, PA-C

• Pediatrics Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.