Angelina Onofre Peterson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209022919 Issued in IL

Practice address

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

Phone

(262) 875-5070

Fax

(866) 384-9486

NPI assigned

May 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Maple Medical SC

  • Physical Medicine & Rehabilitation Physician
  • Waukesha, WI
  • NPI 1487152104
  Medicare reassignment NPD
• Oak Medical SC

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1669910345
  Medicare reassignment NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1508431503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANGELINA",
        "middle_name": "ONOFRE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "1149333",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Frances Peters
• Deborah J. Petersen, MD
• Eryn Petersen
• Gerald D Petersen, D.D.S.
• Greta Petersen
• Dawn Peterson, LPN
• Katherine V Peterson, RD
• Shirley Peterson, BS
• Stephanie E Peterson, LSW
• Heather Pettine, SAC-IT

• Nurse Practitioner in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.