Active NPI
Ronald J. Peterson, M.D.
- Specialist
- Minneapolis, MN
National Provider Identifier
1609827781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 23275
- Practice address
- 801 Nicollet Mall
Suite 400
Minneapolis, MN 55402-2500 - Phone
- (612) 333-2503
- NPI assigned
- May 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 23275 | MN | Primary |
Addresses
Primary practice location
801 Nicollet Mall
Suite 400
Minneapolis, MN 55402-2500
Mailing address
801 Nicollet Mall
Suite 400
Minneapolis, MN 55402-2500
Phone (612) 333-2503
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26399 | Other | MN | AMERICA'S PPO |
| 30400000 | Medicaid | WI | |
| FP9041001070 | Other | MN | PREFERRED ONE |
| 13724PE | Other | MN | BLUE CROSS BLUE SHIELD |
| HP14163 | Other | MN | HEALTH PARTNERS |
| 0700065 | Other | MN | MEDICA DUAL/MEDICARE MA |
| 0701452 | Other | MN | MEDICA |
| A004 | Other | MN | TRICARE WEST/CHAMPUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1609827781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 NICOLLET MALL",
"address_2": "SUITE 400",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022500",
"telephone_number": "612-333-2503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 NICOLLET MALL",
"address_2": "SUITE 400",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022500",
"telephone_number": "612-333-2503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "RONALD",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-13",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "23275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "26399",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30400000",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "FP9041001070",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "13724PE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP14163",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA DUAL/MEDICARE MA",
"identifier": "0700065",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0701452",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE WEST/CHAMPUS",
"identifier": "A004",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.