Active NPI
Alisa Gay Peterson, DO
- Internal Medicine Physician
- Stephenville, TX
National Provider Identifier
1609842525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- L7109
- Practice address
- 411 N Belknap St
Stephenville, TX 76401-3415 - Phone
- (254) 965-1152
- Fax
- (254) 965-1156
- NPI assigned
- Feb 28, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L7109 | TX | Primary |
Addresses
Primary practice location
411 N Belknap St
Stephenville, TX 76401-3415
Mailing address
PO Box 910042
Dallas, TX 75391-0042
Phone (972) 788-1692
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8F3319 | Other | TX | BLUE CROSS BLUE SHIELD |
| TX6027610 | Other | TX | CHAMPUS |
| 161152702 | Medicaid | TX | |
| P00322298 | Other | TX | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Ohio State University College of Homeopathic Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brazos Physician Services, PA
Practice addresses (Care Compare)
1310 Paluxy Rd
Granbury, TX 76048-5655
Phone (817) 573-2273
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 43.55 of 100
- Quality
- 7.63
- Improvement activities
- 40
- Cost
- 81.19
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03411 | IA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Granbury Hospital-Based Professional Services | Current | Accepting new patients | |
| Granbury Hospital Corporation | Past | Accepting new patients | |
| Des Moines University Osteopathic Medical Center | Internal Medicine | Past | Accepting new patients |
| Deuteronomy | Past | Accepting new patients | |
| Quantum Emergency Physicians PA | Internal Medicine | Past | Accepting new patients |
Locations
1310 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-2273
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Granbury, TX
- NPI 1689443467
-
- Hospitalist Physician
- Mansfield, TX
- NPI 1518237429
-
- General Practice Physician
- Kaufman, TX
- NPI 1386665495
-
- General Acute Care Hospital
- Granbury, TX
- NPI 1114998911
-
- Family Medicine Physician
- Des Moines, IA
- NPI 1164475760
Internal Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1659323772
-
- General Acute Care Hospital
- Granbury, TX
- NPI 1114998911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211328000000",
"number": "1609842525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 910042",
"city": "DALLAS",
"state": "TX",
"postal_code": "753910042",
"telephone_number": "972-788-1692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N BELKNAP ST",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764013415",
"telephone_number": "254-965-1152",
"fax_number": "254-965-1156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ALISA",
"middle_name": "GAY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-28",
"last_updated": "2008-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "L7109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8F3319",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "TX6027610",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "161152702",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00322298",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stephenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.
- 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.