Individual provider Active NPI

Katelyn Annette Peters, MD

  • Internal Medicine Physician
  • Stoughton, WI
National Provider Identifier
1548898182
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
84406 Issued in WI
Practice address
1001 Nygaard St
Stoughton, WI 53589-5495
Phone
(608) 877-2660
Fax
(608) 877-2667
NPI assigned
Mar 30, 2020
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 036-162068 IL
Internal Medicine Physician 207R00000X 125076386 IL
Internal Medicine Physician 207R00000X 84406 WI Primary

Addresses

Primary practice location

1001 Nygaard St
Stoughton, WI 53589-5495

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone (847) 318-9340

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kpeters264238@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kpeters947974@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230710001953 IL Practitioner - Internal Medicine 6800255720
I20240809002089 WI Practitioner - Internal Medicine 6800255720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1001 Nygaard St
Stoughton, WI 53589-5495
Phone (608) 877-2660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-162068ILMDInternal Medicine Physician
125076386ILMDInternal Medicine Physician
84406WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 1, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 1, 2024 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

1001 Nygaard St
Stoughton, WI 53589
Phone (608) 265-7740

Interoperability endpoints

  • Direct secure messaging: kpeters264238@direct.myadvocateaurora.org
  • Direct secure messaging: kpeters947974@direct.uwhealth.org

Organizations & group practices 3

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 8

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1548898182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NYGAARD ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535895495",
            "telephone_number": "608-877-2660",
            "fax_number": "608-877-2667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Ballard Rd",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681005",
            "country_code": "US",
            "telephone_number": "847-318-9340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KATELYN",
        "middle_name": "ANNETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-162068",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125076386",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "84406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeters264238@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Ballard Rd",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Ballard Rd",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeters947974@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1001 Nygaard St",
            "city": "Stoughton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535895495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

Verify at the official NPI Registry.