Jon David Peterson, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

513 Issued in MN

Practice address

49725 County 83
Staples, MN 56479-5280

Phone

(218) 894-1515

Fax

(218) 894-8767

NPI assigned

Feb 27, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Podiatry

Education

College of Podiatric Med and Surgery, Des Moines University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Health System 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpeterson623304@direct.ochin.org

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.

• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362

  MN

  Medicare reassignment Care Compare group NPD
• Lakewood Health System

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823

  MN

  Medicare reassignment Care Compare group NPD
• Swift County-Benson Hospital

  • Critical Access Hospital
  • Benson, MN
  • NPI 1174529002

  MN

  Medicare reassignment NPD
• Lakewood Health System

  • Community/Retail Pharmacy
  • Pillager, MN
  • NPI 1396519906
  Care Compare group NPD
• Lakewood Health System

  • Durable Medical Equipment & Medical Supplies
  • Staples, MN
  • NPI 1003807173
  Care Compare group
• Lakewood Health System

  • Rural Health Clinic/Center
  • Eagle Bend, MN
  • NPI 1093706160
  Care Compare group
• Lakewood Health System

  • Medicare Defined Swing Bed Hospital Unit
  • Staples, MN
  • NPI 1386635456
  Care Compare group
• Lakewood Health System

  • Home Health Agency
  • Staples, MN
  • NPI 1477544542
  Care Compare group
• Lakewood Health System

  • Community/Retail Pharmacy
  • Staples, MN
  • NPI 1508630112
  Care Compare group
• Lakewood Health System

  • Community/Retail Pharmacy
  • Staples, MN
  • NPI 1679347348
  Care Compare group
• Lakewood Health System

  • Nursing Facility/Intermediate Care Facility
  • Staples, MN
  • NPI 1699766733
  Care Compare group
• Lakewood Health System

  • Rural Health Clinic/Center
  • Pillager, MN
  • NPI 1811988983
  Care Compare group

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1508832676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LICENSE",
            "identifier": "513",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Lee Olander, CNP
• Kylie Olson
• Alexis B Otteson, DNP, APRN, CNM
• Rachel Ann Paryzek
• Colton Paskewitz, DPT
• Leann Pettow, APRN
• Amber Rasinski, FNP-C
• Travis John Rasinski, DPT
• Elizabeth Joy Redemske, DC
• Jennifer Riley, MD

• All providers in Staples, MN
• Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.