Shane Stean Peterson, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

OS22276 Issued in FL

Practice address

601 E Rollins St
Adventhealth Medical Group Radiology at Central Florida
Orlando, FL 32803-1248

Phone

(407) 200-2355

NPI assigned

Apr 20, 2019

Last updated

Sep 8, 2025By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, FL, CT, KY4 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 4

Specialty

Diagnostic Radiology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Florida Radiology Imaging at Lake Mary LLCGroup PAC ID 1254311137, 273 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Adventhealth Deland Hospital, Deland, FL, CCN 100045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-jefferson
• Direct secure messaging: speterson444055@direct.vumc.org

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group Radiology

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1073785044

  CT, KY

  Medicare reassignment Care Compare group NPD
• Florida Radiology Imaging at Lake Mary, LLC

  dba AdventHealth Imaging

  • Diagnostic Radiology Physician
  • Lake Mary, FL
  • NPI 1740256494

  CT

  Medicare reassignment Care Compare group NPD
• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment NPD
• Adventhealth Imaging Center Innovation

  • Clinic/Center
  • Orlando, FL
  • NPI 1841936879
  NPD
• Connecticut Imaging Partners, LLC

  • Diagnostic Radiology Physician
  • Wethersfield, CT
  • NPI 1740315761
  NPD
• Farmington Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Farmington, CT
  • NPI 1275987802
  NPD
• Jefferson Radiology, PC

  • Diagnostic Radiology Physician
  • Hartford, CT
  • NPI 1396795951
  NPD
• Mayo Clinic

  • Clinical Medical Laboratory
  • Rochester, MN
  • NPI 1083249577
  NPD
• Tic, LLC

  dba Tolland Imaging Center

  • Diagnostic Radiology Physician
  • Tolland, CT
  • NPI 1457702813
  NPD

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

• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando Outreach Laboratory

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Memorial Hospital-West Volusia Inc

  dba AdventHealth DeLand

  • General Acute Care Hospital
  • Deland, FL
  • NPI 1649367269
  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  dba AdventHealth New Smyrna Beach

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1609439066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 946414",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303946414",
            "telephone_number": "407-200-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "address_2": "ADVENTHEALTH MEDICAL GROUP RADIOLOGY AT CENTRAL FLORIDA",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-200-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHANE",
        "middle_name": "STEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-20",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS22276",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "069426",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "76770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynesha Dorthea Peterson, LAT, ATC
• Jaxon Peterson
• Kent G. Peterson, LMHC
• Kimberly K Peterson, OTR/L
• Patricia Ann Peterson
• Ima Petion
• Marie Fabiola Petion
• Fredely Petiote, M.D.
• Yolande Petit Frere
• Mariose Petit-Homme

• Diagnostic Radiology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.