Shawn M. Peterson, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

OS018116 Issued in PA

Practice address

25 S 9TH St FL 1
Philadelphia, PA 19107-4408

Phone

(215) 955-1200

Fax

(215) 923-6808

NPI assigned

May 21, 2012

Last updated

Dec 19, 2018By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Physical Medicine and Rehabilitation

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Jefferson Radiation Oncology, LLC

  • Radiation Oncology Physician
  • Metairie, LA
  • NPI 1619927910
  NPD (past)

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

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1508126806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S 9TH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074408",
            "telephone_number": "215-955-1200",
            "fax_number": "215-923-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S 9TH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074408",
            "telephone_number": "215-955-1200",
            "fax_number": "215-923-6808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Crescent Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191121016",
            "country_code": "US",
            "telephone_number": "215-503-3321",
            "fax_number": "215-503-7180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHAWN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OS018116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103119238",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikia Peterson, LPN
• Ricky Karl Peterson, RN
• Rita Peterson, L.M.F.T., L.P.C.
• Ryan Francis Peterson, CPNP-AC
• Sara Peterson, M.D.
• Victor Jerome Peterson Sr., MSW
• Anne Louise Petherbridge, DPT
• Laura Catherine Petishnok, MD, MS
• Angetta M Petit, CRNA
• Kassandra Petit, NP

• Physical Medicine & Rehabilitation Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.