Scott Peterson, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

5101019986 Issued in MI

Practice address

3777 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2630

Phone

(763) 421-7420

Fax

(763) 421-0730

NPI assigned

Jan 4, 2016

Last updated

Mar 17, 2018By the provider in NPPES

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 MN, 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

Specialty

Ophthalmology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians

Edina Eye Physicians and Surgeons PAGroup PAC ID 1355382698, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.52 of 100Reported as group

Quality

80.37

Promoting interoperability

96

Improvement activities

40

Cost

74.71

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: speterson366501@excellian.direct.allina.com

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.

• Edina Eye Physicians and Surgeons PA

  dba Twin Cities Eye Consultants

  • Ophthalmology Physician
  • Waconia, MN
  • NPI 1538264981
  Medicare reassignment Care Compare group NPD
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922

  MN

  Medicare reassignment Care Compare group NPD
• Edina Eye Physicians and Surgeons PA

  • Optometrist
  • Princeton, MN
  • NPI 1427149442

  Ophthalmology

  NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1598121808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332630",
            "telephone_number": "763-421-7420",
            "fax_number": "763-421-0730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "168 S Howell St",
            "address_purpose": "LOCATION",
            "city": "Hillsdale",
            "state": "MI",
            "postal_code": "492422040",
            "country_code": "US",
            "telephone_number": "517-437-5192",
            "fax_number": "517-437-5194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SCOTT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5101019986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Peterson, CRNA
• Jana Peterson, RDH
• Kyle K Peterson, CRNA
• Paige Peterson, LAT, ATC
• Rachel Peterson, LPT
• Scott M Peterson, CRNA
• Shelley Karee Peterson
• Tammy Hartnett Peterson, OD
• Terri Jo Peterson, NP
• Alicia Petroff, LPCC

• Ophthalmology Physician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.