Individual provider Active NPI

Deborah Ann Peterson, PA

  • Physician Assistant
  • Noblesville, IN
National Provider Identifier
1609159730
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001332A Issued in IN
Practice address
5540 Pebble Village LN Ste 200
Noblesville, IN 46062-7411
Phone
(317) 900-4060
Fax
(317) 900-4698
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001332A IN Primary

Addresses

Primary practice location

5540 Pebble Village LN Ste 200
Noblesville, IN 46062-7411

Mailing address

5540 Pebble Village LN Ste 200
Noblesville, IN 46062-7411
Phone (317) 900-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000750 IN Practitioner - Physician Assistant 6901070507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perryman RheumatologyGroup PAC ID 2365895802, 3 clinicians

Practice addresses (Care Compare)

5540 Pebble Village LN
Suite 200
Noblesville, IN 46062-7411
Phone (317) 900-4891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001332AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allcare Rheumatology, LLC PastSince Jun 1, 2023 Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1609159730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 PEBBLE VILLAGE LN STE 200",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460627411",
            "telephone_number": "317-900-4060",
            "fax_number": "317-900-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 PEBBLE VILLAGE LN STE 200",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460627411",
            "telephone_number": "317-900-4060",
            "fax_number": "317-900-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001332A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.