Active NPI
Ted Steven Peterson, DPM
- Foot Surgery Podiatrist
- Aurora, OH
National Provider Identifier
1598780553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 36.001787
- Practice address
- 9 E Garfield Rd
Aurora, OH 44202-6713 - Phone
- (330) 562-2211
- NPI assigned
- Jul 12, 2006
- Last updated
- Jul 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 36.001787 | OH | Primary |
Addresses
Primary practice location
9 E Garfield Rd
Aurora, OH 44202-6713
Mailing address
10440 Wye Road
Chesterland, OH 44026-3326
Phone (440) 285-9086
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0321904 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071126000499 | OH | Practitioner - Podiatry | 0749378859 | Practice locations: Aurora, OH |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36.001787 | OH | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Foot and Ankle Associates | Past | Accepting new patients |
Interoperability endpoints
- tpeterson219582@ehrdirect.uhhospitals.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1598780553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10440 WYE ROAD",
"city": "CHESTERLAND",
"state": "OH",
"postal_code": "440263326",
"telephone_number": "440-285-9086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 E GARFIELD RD",
"city": "AURORA",
"state": "OH",
"postal_code": "442026713",
"telephone_number": "330-562-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TED",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "OH",
"license": "36.001787",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0321904",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.