Adam B Petersen, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

2012015563 Issued in MO

Practice address

3801 S. National
Springfield, MO 65807

Phone

(417) 269-6000

NPI assigned

Sep 5, 2012

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

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

University of Missouri, Kansas City, School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

Merit-based Incentive Payment System (MIPS)

Final score

82.56 of 100Reported as group

Quality

76.07

Promoting interoperability

100

Improvement activities

40

Cost

65.79

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apetersen148208@direct.saint-lukes.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.

• Saint Luke'S Physician Group Inc

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1093263717
  Medicare reassignment Care Compare group NPD
• Ozark Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Springfield, MO
  • NPI 1831109586
  Medicare reassignment NPD
• Granger Optical LLC

  • Eyewear Supplier
  • West Valley City, UT
  • NPI 1750484945
  NPD (past)

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

• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke'S Hospital of Kansas City

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1518216613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E. PRIMROSE SUITE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S. NATIONAL",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65807",
            "telephone_number": "417-269-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ADAM",
        "middle_name": "B",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2012015563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Peters, NP
• Jason Ray Peters, MS, LPC, NCC
• Jessica Raeann Peters, NP
• Sheila Peters, RN, IBCLC
• Stacy Peters, OTR
• Jefferson L. Petersen, CRNA
• Larry D. Petersen, M.D.
• Nathan David Petersen, RN
• Craig A Peterson, MD
• James NC Peterson, DC

• Anesthesiologist Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Anesthesiologist Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.