Individual provider Active NPI

Andrew R. Peterson, M.D.

  • Pediatrics Physician
  • Iowa City, IA
National Provider Identifier
1528023504
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-39155 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1007
Phone
(319) 353-8392
Fax
(319) 384-6295
NPI assigned
Apr 20, 2006
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 48969 WI
Pediatrics Physician 208000000X MD-39155 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1007

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1007
Phone (319) 353-8392

Other practice location 1

2701 Prairie Meadow Dr
Iowa City, IA 52242-8001
Phone (319) 384-7070

Other practice location 2

105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000

Other practice location 3

701 W Forevergreen Rd
North Liberty, IA 52317-9848
Phone (319) 356-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20101007000007 IA Practitioner - Pediatric Medicine 8022118173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Wisconsin School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians
Unified Therapy Services, IncGroup PAC ID 7618985714, 124 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

2701 Prairie Meadow Dr
Iowa City, IA 52242-8001
Phone (319) 384-7070

4135 Pennsylvania Ave
Dubuque, IA 52002-2628

701 W Forevergreen Rd
Univ of Ia Health Care Med Ctr N Liberty
North Liberty, IA 52317-9848
Phone (319) 485-0550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-39155IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Sep 15, 2010 Accepting new patients
State University of Iowa Pediatrics CurrentSince Sep 15, 2010 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
State University of Iowa Past Accepting new patients

Locations

105 E 9th St
Iowa City, IA 52241
Phone (319) 467-2000

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-2633

200 Hawkins Dr
#H
Iowa City, IA 52242

701 W Forevergreen Rd
North Liberty, IA 52317
Phone (319) 356-2223

Interoperability endpoints

  • Direct secure messaging: apeterson55714@uihcdirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1528023504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421007",
            "telephone_number": "319-353-8392",
            "fax_number": "319-384-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421007",
            "telephone_number": "319-353-8392",
            "fax_number": "319-384-6295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Prairie Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522428001",
            "country_code": "US",
            "telephone_number": "319-384-7070",
            "fax_number": "319-356-4705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412209",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 W Forevergreen Rd",
            "address_purpose": "LOCATION",
            "city": "North Liberty",
            "state": "IA",
            "postal_code": "523179848",
            "country_code": "US",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANDREW",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WI",
            "license": "48969",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-39155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.